Increasing participation in fecal screening tests is a major challenge in countries that have implemented colorectal cancer screening programs.

Dr Amit Singal and colleagues determined whether providing general practitioners (GPs) a list of patients who are nonadherent to colorectal cancer screening enhances patient participation in fecal immunochemical testing (FIT).

A 3-group, cluster-randomized study was conducted from 2015, to 2016, on the west coast of France, with GPs in 801 practices participating and involving adult patients who were at average risk of colorectal cancer, and not up-to-date with colorectal cancer screening. 

The final follow-up date was 2016.

The research team randomly assigned gGeneral practitioners to 1 of 3 groups.

The team reported that 496 received a list of patients who had not undergone colorectal cancer screening, 495 received a letter describing region-specific colorectal cancer screening adherence rates, and 455 did not receive any reminders.

The researchers’ primary end point was patient participation in colorectal cancer screening 1 year after the intervention.

Among 1482 randomized GPs, 1446 participated; of the 33,044 patients of these GPs, follow-up at 1 year was available for 95%.

At 1 year, the team observed that 25% of patients in the specific reminders group, 22% in the generic reminders group, and 21% in the usual care group participated in the FIT screening. 

The research team found that between-group differences were 3% for the patient-specific reminders group vs the generic reminders group, 4% for the patient-specific reminders group vs the usual care group, and 1% for generic reminders group vs the usual care group.

Dr Singal’s team concludes, “Providing French GPs caring for adults at average risk of colorectal cancer with a list of their patients who were not up-to-date with their colorectal cancer screening resulted in a small but significant increase in patient participation in FIT screening at 1 year compared with patients who received usual care.”

“Providing GPs with generic reminders about regional rates of colorectal cancer screening did not increase screening rates compared with usual care.”