Trial reportClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2026
Behavioral Interventions Improve Mailed Colorectal Cancer Screening Among Overdue Patients in a Randomized Trial.
Trial report in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05341622 (Pragmatic Trial of Behavioral Interventions to Increase Response to Mailed FIT Outreach), which is not on this map. Not yet cited in PubMed.
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Pragmatic Trial of Behavioral Interventions to Increase Response to Mailed FIT Outreach
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11 authors.
Funding
Abstract
BACKGROUND &
aimsMailed fecal immunochemical testing (FIT) can boost colorectal cancer screening (CRC) rates, but response rates remain limited. We evaluated if behavioral interventions increased response rates.
methodsThis pragmatic randomized trial with a 2 × 2 × 2 factorial design included primary care patients aged 50 to 74 years who were overdue for CRC screening. Patients were randomized 1:1 to receive a health system-branded blue box or a standard envelope. Patients were concurrently randomized 1:1 to receive or not receive text reminders. Patients were also concurrently randomized 1:1 to receive a reminder letter. The primary outcome was the proportion who completed a FIT within 4 months.
resultsAmong 5244 patients included, the mean age was 59.6 years (standard deviation [SD], 7.3 years); 35.8% were Black and 53% were White. At 4 months, 17.8% (95% confidence interval [CI], 16.3%-19.2%) who received the box, compared with 18.0% (95% CI, 16.5%-19.5%) who received the standard envelope, completed FIT, an absolute difference of -0.2% (95% CI, -2.3 to 1.9%; P = .85). Among those who received text messaging, 21.2% (95% CI, 19.6%-22.8%) completed FIT compared with 14.6% (95% CI, 13.2%-15.9%) of those who did not, an absolute difference of 6.6% (95% CI, 4.6%-8.7%; P < .001). Among those that received the mailed reminder, 20.3% (95% CI, 18.7%-21.8%) completed FIT compared with 15.5% (95% CI, 14.1%-16.9%) of those who did not, an absolute difference of 4.8% (95% CI, 2.7%-6.9%; P < .001).
conclusionsBehaviorally informed text messaging and mailed reminders significantly increased screening completion, but the health system-branded box did not increase response rates. CLINICALTRIALS: gov, Number: NCT05341622.
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