A Randomized Controlled Trial Testing Provision of Fecal and Blood Test Options on Participation for Colorectal Cancer Screening

• Published in: Cancer prevention research (Philadelphia, Pa.) Vol. 12; no. 9; pp. 631 - 640
• Main Authors: Symonds, Erin L, Hughes, Donna, Flight, Ingrid, Woodman, Richard, Chen, Gang, Ratcliffe, Julie, Pedersen, Susanne K, Fraser, Robert J L, Wilson, Carlene J, Young, Graeme P
• Format: Journal Article
• Language: English
• Published: United States 01.09.2019
• ISSN: 1940-6207; 1940-6215
• DOI: 10.1158/1940-6207.CAPR-19-0089

Suboptimal participation is commonly observed in colorectal cancer screening programs utilizing fecal tests. This randomized controlled trial tested whether the offer of a blood test as either a "rescue" strategy for fecal test nonparticipants or an upfront choice, could improve participation. A total of 1,800 people (50-74 years) were randomized to control, rescue, or choice groups ( = 600/group). All were mailed a fecal immunochemical test (FIT, OC-Sensor, Eiken Chemical Company) and a survey assessing awareness of the screening tests. The rescue group was offered a blood test 12 weeks after FIT nonparticipation. The choice group was given the opportunity to choose to do a blood test (Colvera, Clinical Genomics) instead of FIT at baseline. Participation with any test after 24 weeks was not significantly different between groups (control, 37.8%; rescue, 36.9%; choice, 33.8%; > 0.05). When the rescue strategy was offered after 12 weeks, an additional 6.5% participated with the blood test, which was greater than the blood test participation when offered as an upfront choice (1.5%; < 0.001). Awareness of the tests was greater for FIT than for blood (96.2% vs. 23.1%; < 0.0001). In a population familiar with FIT screening, provision of a blood test either as a rescue of FIT nonparticipants or as an upfront choice did not increase overall participation. This might reflect a lack of awareness of the blood test for screening compared with FIT.