Study: At-home colonoscopy tests decrease colon cancer screenings

Aug. 30 (UPI) — The availability of at-home colon cancer screenings decreases the rate of testing for the deadly disease, new research shows.

Fewer than 50 percent of people who have the kits use them for colonoscopies, according to findings published Friday in JAMA Network Open.

“As clinicians, we should think carefully about the choices that we offer to patients: While they’re well-meaning and seemingly more patient-centered, choices may actually be overwhelming and could impede decision-making,” the study’s lead author, Shivan Mehta, MD, MBA, associate chief innovation officer at Penn Medicine and an assistant professor of Medicine, said in a press release. “It is important for us to simplify choices as much as possible, but also think about how we frame them.”

Roughly 1 in 3 middle-aged adults in the United States aren’t up to date on their colonoscopies, according to the Centers for Disease Control and Prevention.

For the trial, conducted from November 2017 to May 2018, researchers recruited 438 patients between ages 50 and 74 who were overdue for colorectal screenings.

All participants got letters from primary care physicians explaining the benefits of the screenings. One group also got a phone number to call to schedule a colonoscopy. If they didn’t schedule an appointment, they got a follow-up letter with the same information.

Another group received both the number and the letter. If they didn’t get the colonoscopy within four weeks, they got another letter plus a FIT kit home colonoscopy test containing instructions and a stamped envelope to return it.

A third group got the number to schedule a colonoscopy and the FIT kit. If neither screening was completed, they got a letter with information about how to schedule a colonoscopy and another FIT kit.

In all, 90 percent of people in the first group were screened for colonoscopies compared to 52 percent of people in the second group. Only 38 percent of people in the third group used their at-home kits for screenings.

These findings align with another study that showed only 24 percent of people used the at-home colonoscopy kits.

The Centers for Disease Control and Prevention recommends people between ages 50 and 75 getting an in-office colonoscopy every five years or a FIT screening every 10 years.

Colon cancer is the third leading cause of cancer-related death in the United States, according to the agency.

“Specifically, we would like to explore how long we should wait before we offer stool testing when patients do not participate in colonoscopy,” Mehta said. “This may offer a clue as to whether there is a better timing option that might increase screening rates while accounting for the need to repeat stool testing annually.”

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