Effectiveness of Interventions to Increase Colorectal Cancer Screening Among American Indians and Alaska Natives

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Haverkamp, Donald ; English, Kevin ; Jacobs-Wingo, Jasmine ; Tjemsland, Amanda ; Espey, David
• Description:
  Introduction
  
  Screening rates for colorectal cancer are low in many American Indian and Alaska Native (AI/AN) communities. Direct mailing of a fecal immunochemical test (FIT) kit can address patient and structural barriers to screening. Our objective was to determine if such an evidence-based intervention could increase colorectal cancer screening among AI/AN populations.
  
  Methods
  
  We recruited study participants from 3 tribally operated health care facilities and randomly assigned them to 1 of 3 study groups: 1) usual care, 2) mailing of FIT kits, and 3) mailing of FIT kits plus follow-up outreach by telephone and/or home visit from an American Indian Community Health Representative (CHR).
  
  Results
  
  Among participants who received usual care, 6.4% returned completed FIT kits. Among participants who were mailed FIT kits without outreach, 16.9% returned the kits — a significant increase over usual care (P < .01). Among participants who received mailed FIT kits plus CHR outreach, 18.8% returned kits, which was also a significant increase over usual care (P < .01) but not a significant increase compared with the mailed FIT kit–only group (P = .44). Of 165 participants who returned FIT kits during the study, 39 (23.6%) had a positive result and were referred for colonoscopy of which 23 (59.0%) completed the colonoscopy. Twelve participants who completed a colonoscopy had polyps, and 1 was diagnosed with colorectal cancer.
  
  Conclusion
  
  Direct mailing of FIT kits to eligible community members may be a useful, population-based strategy to increase colorectal cancer screening among AI/AN people.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 2020; 17
• ISSN:
  1545-1151
• Pubmed ID:
  32678062
• Pubmed Central ID:
  PMC7380299
• Document Type:
  Journal Article
• Volume:
  17
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:cd1e1ed94647f8b41fbec14ad8a3998ee7ce7e80800ff03032e43e368cae58d4005696842aac23b9f1e05c2252d62114d266e58fb274a4961262e584553cd3d3
• Download URL:
  https://stacks.cdc.gov/view/cdc/91687/cdc_91687_DS1.pdf
• File Type:
  [PDF - 429.63 KB ]