NIH estimates 135430 new cases of colorectal cancer in 2017 worldwide. Colorectal cancer (CRC) will be responsible for 8,4% cancer-related deaths worldwide. Given colorectal cancer incidence and mortality rate, it becomes obvious that treatment is somewhat effective, as 64% patients survive beyond 5 years.
In terms of saving lives, early detection strategies are generally much more efficacious than aggressive treatment on later stages. Modern technology is not only associated with sedentary lifestyle, a well-known risk factor for CRC. It also can be helpful in early diagnosis.
Researchers from Hong-Kong Chinese University have studied, to what extent interactive reminders increase patients’ adherence to prophylactic screening.
A total of 629 patients were randomized into 3 groups. In the control group, participants were told in 2015 that they should visit the screening center for annual FIT pickup in the same calendar month of 2016. In the SMS group, subjects received a 1-way SMS, highlighting the importance of CRC screening, and notifying date and location of fecal immunochemical test (FIT) pickup on their mobile. In the telephone group, participants received a call from a trained health care physician with the same message as the SMS, but an interactive conversation was permitted. The interventions were delivered 1 month before the expected date of participant return for the second round of screening.
The FIT pickup rate was 62.3%, 78.5%, and 89.8% for the control, SMS, and telephone groups, respectively (p < .001). Delayed pick up of FIT (ie, 1 month after the anticipated return date) occurred in 10.6%, 6.7%, and 3.4% of the corresponding groups, respectively (p = .020).
Results are indicative that telephone reminder is significantly more efficacious. Screening programs in other settings with low adherence should consider telephone-based or SMS strategies to maximize the mortality benefits of screening. Approximately 4,3% of men and women will be diagnosed with CRC at some point of their lives.