Evidence map›Paper›PMID 26535565›Full record

Trial reportCancer2016

Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: A randomized controlled trial in a safety-net health system.

Amit G Singal, Samir Gupta, Jasmin A Tiro, Celette Sugg Skinner, Katharine McCallister, Joanne M Sanders, Wendy Pechero Bishop, Deepak Agrawal, Christian A Mayorga, Chul Ahn and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06929481 (Screening With Liquid Biopsies to Address Colorectal Cancer Inequities), which is not on this map. Cited by 101 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06929481 naactive not recruitingnot on this mapstarted 2025, after this paper: background citation

Screening With Liquid Biopsies to Address Colorectal Cancer Inequities

TypeinterventionalSponsorUniversity of California, San DiegoRan2025 to 2026Enrolled340ConditionsColorectal Cancer Screening, Colorectal Cancer (CRC)ArmsCell free DNA (cfDNA) blood test, At home Fecal Immunochemical Test (FIT) or Colonoscopy
3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  9. Multilevel Interventions to Improve Colorectal Cancer Screening in an Urban Native American Community: A Pilot Randomized Clinical Trial.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024
    Trial
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  11. Video brochures in a mailed fecal immunochemical test outreach program provide cancer screening information in a user-friendly format for rural Appalachian community members.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024
    Trial
  12. Effectiveness and Cost of an Enhanced Mailed Fecal Test Outreach Colorectal Cancer Screening Program: Findings from the PROMPT Stepped-Wedge Trial.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023
    Trial
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  14. Randomized Controlled Trial of Advance Notification Phone Calls vs Text Messages Prior to Mailed Fecal Test Outreach.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021
    Trial
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  18. An RCT to Increase Breast and Colorectal Cancer Screening.American journal of preventive medicine · 2020
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  19. Repeat Annual Colorectal Cancer Screening in Rural Community Clinics: A Randomized Clinical Trial to Evaluate Outreach Strategies to Sustain Screening.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2020
    Trial
  20. Trial

41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Amit G SingalDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Samir GuptaVeterans Affairs San Diego Health Care System, San Diego, California.
Jasmin A TiroDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Celette Sugg SkinnerDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Katharine McCallisterDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Joanne M SandersDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Wendy Pechero BishopDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Deepak AgrawalDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Christian A MayorgaDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Chul AhnDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Adam C LoewenDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Noel O SantiniParkland Health and Hospital System, Dallas, Texas.
Ethan A HalmDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.

Funding

UT Southwestern Medical Center Simmons Comprehensive Cancer CenterP30CA142543 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI MELANIE H. COBB · 2010 to 2026
$53.7M
UT Southwestern Center for Translational Medicine (UL1/KL2/TL1)UL1TR001105 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$24.5M
Parkland-UT Southwestern PROSPR Center Colon Cancer Screening in a Safety netU54CA163308 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI SKINNER, CELETTE SUGG · 2011 to 2017
$8.0M
UT Southwestern Center of Patient-Centered Outcomes Research (PCOR)R24HS022418 · AHRQ · UT SOUTHWESTERN MEDICAL CENTER · PI HALM, ETHAN A · 2013 to 2017
$5.0M
UT Southwestern Center for Translational Medicine (UL1/KL2/TL1KL2TR001103 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$4.0M
AHRQ HHS R24 HS022418NCATS NIH HHS KL2 TR001103NCATS NIH HHS UL1 TR001105NCATS NIH HHS UL1TR001105NCI NIH HHS P30 CA142543NCI NIH HHS U54 CA163308NCI NIH HHS U54CA163308-01
6 · The paper itself

Abstract

backgroundThe effectiveness of colorectal cancer (CRC) screening is limited by underuse, particularly among underserved populations. Among a racially diverse and socioeconomically disadvantaged cohort of patients, the authors compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase screening participation rates, compared with usual visit-based care.

methodsPatients aged 50 to 64 years who were not up-to-date with CRC screening but used primary care services in a large safety-net health system were randomly assigned to mailed FIT outreach (2400 patients), mailed colonoscopy outreach (2400 patients), or usual care with opportunistic visit-based screening (1199 patients). Patients who did not respond to outreach invitations within 2 weeks received follow-up telephone reminders. The primary outcome was CRC screening completion within 12 months after randomization.

resultsBaseline patient characteristics across the 3 groups were similar. Using intention-to-screen analysis, screening participation rates were higher for FIT outreach (58.8%) and colonoscopy outreach (42.4%) than usual care (29.6%) (P <.001 for both). Screening participation with FIT outreach was higher than that for colonoscopy outreach (P <.001). Among responders, FIT outreach had a higher percentage of patients who responded before reminders (59.0% vs 29.7%; P <.001). Nearly one-half of patients in the colonoscopy outreach group crossed over to complete FIT via usual care, whereas <5% of patients in the FIT outreach group underwent usual-care colonoscopy.

conclusionsMailed outreach invitations appear to significantly increase CRC screening rates among underserved populations. In the current study, FIT-based outreach was found to be more effective than colonoscopy-based outreach to increase 1-time screening participation. Studies with longer follow-up are needed to compare the effectiveness of outreach strategies for promoting completion of the entire screening process.

Indexed as

ColonoscopyOccult BloodAdultAgedColorectal NeoplasmsEarly Detection of CancerFemaleHumansImmunohistochemistryMaleMass ScreeningMiddle AgedPrimary Preventioncolonoscopycolorectal cancer screeningfecal immunochemical testnavigationrandomized controlled trialsafety-net health system

Identifiers

PMID26535565
PMCPMC4724227

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.