Screening for colorectal cancer (CRC) reduces mortality, yet more than one third of age-eligible Americans are unscreened.

Dr David Miller and colleagues examined the effect of a digital health intervention, Mobile Patient Technology for Health–CRC (mPATH-CRC), on rates of CRC screening.

The team evaluated 450 patients scheduled for a primary care visit and due for routine CRC screening.

An iPad application that displays a CRC screening decision aid, lets patients order their own screening tests, and sends automated follow-up electronic messages to support patients.

The primary outcome was chart-verified completion of CRC screening within 24 weeks. 

Secondary outcomes were ability to state a screening preference, intention to receive screening, screening discussions, and orders for screening tests. 

All outcome assessors were blinded to randomization.

The researchers found that baseline characteristics were similar between groups; 37% of participants had limited health literacy, and 53% had annual incomes less than $20,000. 

Screening was completed by 30% of mPATH-CRC participants and 15% of those receiving usual care. 

Compared with usual care, more mPATH-CRC participants could state a screening preference, planned to be screened within 6 months, discussed screening with their provider, and had a screening test ordered. 

Half of mPATH-CRC participants “self-ordered” a test via the program.

Dr Miller's team concludes, "A digital health intervention that allows patients to self-order tests can increase CRC screening."

"Future research should identify methods for implementing similar interventions in clinical care."