Noninvasive Test Optimizes Colon Cancer Screening Rates, UTSW Study Finds

DALLAS – Aug. 5, 2013 – A study of nearly 6,000 North Texas patients suggests sweeping changes be made to the standard of care strategy for colorectal screenings, finding that participation rates soared depending on the screening method offered and how patient outreach was done.

The results also suggest that a noninvasive colorectal screening approach, such as a fecal immunochemical tests (FIT) might be more effective in prompting participation in potentially lifesaving colon cancer screening among underserved populations than a colonoscopy, a more expensive and invasive procedure.

Researchers at UT Southwestern and the University of California, San Diego, have found that organized mailing campaigns offering two colorectal cancer tests increased screening rates as much as threefold among uninsured patients.

The study is available online in the Aug. 5 edition of JAMA Internal Medicine.

FIT, a quick and easy test that requires no special preparation, detects small amounts of occult (hidden) blood in a patient’s stool sample. Completed tests are then mailed to a laboratory for analysis. The findings presented in the published paper showed that with the help of a mail campaign, FIT participation tripled, and colonoscopy participation doubled in the study sample.

In the investigation, uninsured patients at John Peter Smith (JPS) Health Network in Fort Worth ages 54 to 64 years and not up to date with their screenings were mailed invitations to use and return a no-cost FIT, or to schedule a no-cost colonoscopy. Both groups also received follow-up telephone calls to promote testing.

“The study suggests that the best approach to offering and delivering screening to underserved populations may be through FIT,” said senior author Dr. Celette Sugg Skinner, associate director of population science and cancer control for the Harold C. Simmons Cancer Center. “Questions for the future are whether superior participation can be maintained in the FIT group [because the test must be repeated every year] and how adherence rates will impact overall screening effectiveness and cost.”

Study authors say the findings raise the possibility that cost-effective, large-scale public health efforts to boost screening may be more successful if noninvasive tests, such as FIT, are offered along with colonoscopy screenings.

The study was conducted by UT Southwestern’s Division of Digestive and Liver Diseases, in conjunction with the Simmons Cancer Center and the Moncrief Cancer Institute, in close collaboration with JPS Health Network.

Other UT Southwestern researchers involved were Dr. Ethan A. Halm, chief of the division of General Internal Medicine; Dr. Chul Ahn, professor of clinical science; Dr. Keith Argenbright, director of the Moncrief Cancer Institute; Dr. Jasmin Tiro, assistant professor of clinical science; Dr. Sandi Pruitt, assistant professor of clinical science; Luisa Valdez, clinical data specialist at the Simmons Cancer Center; Liyue Tong, biostatistical consultant II in clinical science; and Zhuo Geng, a student at UT Southwestern Medical School. The study’s first author is Dr. Samir Gupta, associate professor of clinical medicine at UCSD. Scientists at the Medical University of South Carolina also participated.

Primary funding was provided by the Cancer Prevention and Research Institute of Texas (PP10039.) Additional funding was provided by National Institutes of Health grants (1 KL2 RR024983 and 1U54CA163308-01).

Please visit the Harold C. Simmons Cancer Center to learn more about clinical services for oncology at UT Southwestern, including highly individualized treatments for cancer at the region’s only National Cancer Institute-designated center.

About UT Southwestern Medical CenterUT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has many distinguished members, including five who have been awarded Nobel Prizes since 1985. Numbering more than 2,700, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to nearly 90,000 hospitalized patients and oversee more than 1.9 million outpatient visits a year.

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