A Pilot Study for Using Fecal Immunochemical Testing to Increase Colorectal Cancer Screening in Appalachia, 2008-2009

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Kluhsman, Brenda C. ; Lengerich, Eugene J. ; Spleen, Angela M. ; Bencivenga, Marcyann M. ; Fleisher, Linda ; Miller-Halegoua, Suzanne M. ; Balshem, Andrew ; Paskett, Electra D. ; Schreiber, Paulette ; Dignan, Mark B.
• Description:
  Introduction
  
  The Appalachian region of the United States has disproportionately high colorectal cancer (CRC) death rates and low screening rates. The purpose of this pilot study was to assess acceptability of a take-home fecal immunochemical test (FIT) and the effect of follow-up telephone counseling for increasing CRC screening in rural Appalachia.
  
  Methods
  
  We used a prospective, single-group, multiple-site design, with centralized laboratory reports of screening adherence and baseline and 3-month questionnaires. Successive patients, aged 50 or older, at average CRC risk and due for screening were enrolled during a routine visit to 3 primary care practices in rural Appalachian Pennsylvania and received a free take-home FIT and educational brochure. Those who had not returned the test 2 weeks later were referred for telephone counseling.
  
  Results
  
  Of 232 patients approached, 200 (86.2%) agreed to participate. Of these, 145 (72.5%) completed the FIT as recommended (adherent) and 55 (27.5%) were referred for telephone counseling (nonadherent), of whom 23 (41.8%) became adherent after 1 to 2 counseling sessions, an 11.5 percentage-point increase in screening after telephone counseling and 84% FIT adherence overall. Lack of CRC-related knowledge and perceived CRC risk were the screening barriers most highly associated with nonadherence. Although not statistically significant, the rate of conversion to screening adherence was higher among participants who received telephone counseling compared to an answering machine reminder.
  
  Conclusion
  
  If confirmed in future randomized trials, provider-recommended take-home FIT and follow-up telephone counseling may be methods to increase CRC screening in Appalachia.
  
  
• Subjects:
  Aged Aged, 80 And Over Colorectal Neoplasms Counseling Early Detection Of Cancer Female Health Knowledge, Attitudes, Practice Health Services Accessibility Humans Immunologic Tests Male Middle Aged Occult Blood Patient Acceptance Of Health Care Patient Compliance Pilot Projects Prospective Studies Rural Population Telephone

  More +
• Source:
  Prev Chronic Dis. 2012; 9.
• ISSN:
  1545-1151
• Document Type:
  Journal Article
• Place as Subject:
  Appalachian Region
• Location:
  North America
• Volume:
  9
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:9a4ef15ad16d3873eb29150e91570d35ba35f74c2f104584fa9f7fed6708bee3b7861b978742f2b7e16a656503a4ee9be54a8444aa1c01fbe44a0b2c93c51625
• Download URL:
  https://stacks.cdc.gov/view/cdc/19816/cdc_19816_DS1.pdf
• File Type:
  [PDF - 228.27 KB ]