The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial.

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  • Additional Information
    • Affiliation:
      Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
      Medical Faculty Heidelberg, University of Heidelberg
      Gastroenterologische Schwerpunktpraxis, Dornstadt
      AOK Baden-Wuerttemberg, Stuttgart
      Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg
      National Center for Tumor Diseases (NCT), Heidelberg
      German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg
    • Abstract:
      Background: Participation rates in colorectal cancer screening in Germany are low. We therefore investigated the effectiveness of different invitation models for immunological stool blood tests (fecal immunological tests, FITs). Methods: A randomized controlled trial in 50- to 54-year-old clients of the health insurance provider AOK Baden-Wuerttemberg. A total of 17 532 insured persons were randomized to receive: (A) an invitation letter including a FIT (n = 5850); (B) an invitation letter including an option to request a FIT (n = 5844); or (C) an invitation letter only (n = 5838; control group, routine practice). Reminder letters were sent to half the members of groups A and B, selected at random, after 4 weeks. The primary endpoint was the use of a FIT within 1 year of the date of the invitation letter. IRRID: RR2-10.2196/16413. Registration: DRKS00011858. Results: The invitation letter with a FIT enclosed (A) increased usage from 10% to 29.7% compared with the control group (+19.7% points, p < 0.0001; men: +19.4%, women: +18.8%). The invitation letter with a FIT request option (B) increased usage from 10% to 27.7% (+17.7% points, p < 0.0001; men: +17.7%, women: +17.4%). Reminders increased usage in group A by 7.5% points and in group B by 8.5% points. Participation among women was higher than among men in all groups. The FIT positivity rate was 6.9%. A subsequent colonoscopy was reported for 64.3% of FIT-positive participants, and advanced neoplasia was found in 21.3% of these cases. Conclusion: Letters of invitation that include a FIT and those that offer low-threshold access to a FIT achieve strong, comparable increases in the usage of FIT in the context of colorectal cancer screening.
    • Journal Subset:
      Biomedical; Blind Peer Reviewed; Continental Europe; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed
    • ISSN:
      1866-0452
    • Publication Date:
      In Process
    • Publication Date:
      20200918
    • DOI:
      10.3238/arztebl.2020.0423
    • Accession Number:
      145529614
  • Citations
    • ABNT:
      GRUNER, L. F. et al. The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial. Deutsches Aerzteblatt International, [s. l.], v. 117, n. 25, p. 423–430, 2020. DOI 10.3238/arztebl.2020.0423. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=145529614. Acesso em: 30 out. 2020.
    • AMA:
      Gruner LF, Hoffmeister M, Ludwig L, Meny S, Brenner H. The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial. Deutsches Aerzteblatt International. 2020;117(25):423-430. doi:10.3238/arztebl.2020.0423
    • APA:
      Gruner, L. F., Hoffmeister, M., Ludwig, L., Meny, S., & Brenner, H. (2020). The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial. Deutsches Aerzteblatt International, 117(25), 423–430. https://doi.org/10.3238/arztebl.2020.0423
    • Chicago/Turabian: Author-Date:
      Gruner, Laura Fiona, Michael Hoffmeister, Leopold Ludwig, Stefan Meny, and Hermann Brenner. 2020. “The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial.” Deutsches Aerzteblatt International 117 (25): 423–30. doi:10.3238/arztebl.2020.0423.
    • Harvard:
      Gruner, L. F. et al. (2020) ‘The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial’, Deutsches Aerzteblatt International, 117(25), pp. 423–430. doi: 10.3238/arztebl.2020.0423.
    • Harvard: Australian:
      Gruner, LF, Hoffmeister, M, Ludwig, L, Meny, S & Brenner, H 2020, ‘The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial’, Deutsches Aerzteblatt International, vol. 117, no. 25, pp. 423–430, viewed 30 October 2020, .
    • MLA:
      Gruner, Laura Fiona, et al. “The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial.” Deutsches Aerzteblatt International, vol. 117, no. 25, June 2020, pp. 423–430. EBSCOhost, doi:10.3238/arztebl.2020.0423.
    • Chicago/Turabian: Humanities:
      Gruner, Laura Fiona, Michael Hoffmeister, Leopold Ludwig, Stefan Meny, and Hermann Brenner. “The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial.” Deutsches Aerzteblatt International 117, no. 25 (June 19, 2020): 423–30. doi:10.3238/arztebl.2020.0423.
    • Vancouver/ICMJE:
      Gruner LF, Hoffmeister M, Ludwig L, Meny S, Brenner H. The Effects of Differing Invitation Models on the Uptake of Immunological Fecal Occult Blood Testing: Results from a Randomized Controlled Trial. Deutsches Aerzteblatt International [Internet]. 2020 Jun 19 [cited 2020 Oct 30];117(25):423–30. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=145529614