2019
DOI: 10.1001/jamanetworkopen.2019.10305
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Effect of Sequential or Active Choice for Colorectal Cancer Screening Outreach

Abstract: Key Points Question Does the offering of choice between colonoscopy and fecal immunochemical testing (FIT) change participation in screening outreach? Findings In this 3-arm pragmatic randomized clinical trial of 438 patients, there was no statistically significant increase in screening when offering the choice of FIT compared with colonoscopy only, but fewer patients selected colonoscopy in the choice arms. Meaning Offering the … Show more

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Cited by 17 publications
(14 citation statements)
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“…Because of the pragmatic design, our power calculations were based on the population of eligible patients in each substudy and meaningful differences to justify implementation of the interventions. We estimated that usual care messaging alone (letter only) would result in a 5% response rate based on findings from other screening outreach activities 2030. Our power calculation was based on cluster randomization, but we changed to patient level randomization before enrollment.…”
Section: Methodsmentioning
confidence: 99%
“…Because of the pragmatic design, our power calculations were based on the population of eligible patients in each substudy and meaningful differences to justify implementation of the interventions. We estimated that usual care messaging alone (letter only) would result in a 5% response rate based on findings from other screening outreach activities 2030. Our power calculation was based on cluster randomization, but we changed to patient level randomization before enrollment.…”
Section: Methodsmentioning
confidence: 99%
“…So, what should we do at the population level? Mehta et al 2 grapple with this question in their provocative randomized clinical trial of CRC screening with 3 arms: no choice over screening modality (colonoscopy only), active choice (colonoscopy vs fecal immunochemical test [FIT]), and sequential choice (colonoscopy first and FIT choice for initial nonresponders). The authors report CRC screening completion rates at 4 months of 14.4% (95% CI, 8.7%-20.1%) in the colonoscopy-only arm, 17.1% (95% CI, 11.0%-23.2%) in the sequential choice arm, and 19.9% (95% CI, 13.4%-26.4%) in the active choice arm, with no statistically significant differences between arms.…”
mentioning
confidence: 99%
“…Approximately 56% of individuals aged 50 to 64 years and 72% of those aged 65 to 75 years in the United States undergo CRC screening. 7 Although Mehta et al 2 do not report the study participants' CRC screening history, it is likely that most were previously unscreened. Study patients were in their 50s and 60s; they had not just reached screening eligibility.…”
mentioning
confidence: 99%
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