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Mail, electronic reminders boost cancer screening
Mailed reminders to patients appear to promote colon cancer screening, according to a report in the Feb. 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, electronic reminders to physicians appear to increase screening among patients with more frequent primary care visits.
The study was conducted by Thomas D. Sequist, MD, MPH, of Brigham and Women's Hospital and Harvard Vanguard Medical Associates and assistant professor of medicine and of health care policy at Harvard Medical School, Boston, and colleagues. They studied screening rates and colorectal adenoma (tumor) detection for 21,860 patients (age 50 to 80) of 110 physicians from April 2006 to June 2007. Fifty-five physicians were randomly assigned to receive electronic reminders during office visits with patients overdue for screening. Additionally, 10,930 patients were randomly assigned to receive mailings containing an educational pamphlet, a fecal occult blood test kit, and instructions for direct scheduling of flexible sigmoidoscopy or colonoscopy. Screening rates and detection of colorectal adenomas (tumors) were noted 15 months after the start of the intervention.
Screening rates for patients who received mailings were higher than for those who did not (44% vs. 38.1%). The mailings were more effective among older patients; patients age 50-59 experienced a 3.7% increase, patients age 60-69 had a 7.3% increase and patients age 70-80 experienced a 10.1% increase in screening rates. While patients of physicians receiving electronic reminders had screening rates similar to patients of physicians who did not receive reminders (41.9% vs. 40.2%), electronic reminders tended to increase screening rates among patients with three or more primary care visits (59.5% vs. 52.7%).