TOPLINE:

Personalized messages sent to patients about their risk for advanced colorectal neoplasia (ACN) had no effect on screening rates overall; however, in one of two health systems, the personalized messages increased stool tests.

METHODOLOGY:

• Researchers conducted a study that included 214 primary care providers and 1084 patients who did not have a high risk for colorectal cancer (CRC) and were due for a screening.
• The trial was conducted at 41 primary care clinics across two healthcare systems in the Midwest over a 3-year period starting in November 2020; patients had a mean age of 56.5 years and were primarily women (59.7%) and White (65.1%).
• Patients were randomly assigned to view a video about CRC and screening, either with or without (generic) a personalized message about their risk for ACN; Clinicians received notifications about patients due for a screening, either with or without (generic)a personalized message about the patient’s risk for ACN.
• Researchers assessed whether the intervention affected completion of a screening, including stool tests or colonoscopy, within 6 months.

TAKEAWAY:

• Screening rates were similar whether clinicians received a personalized or generic notification about patient risk (41.5% vs 36.4%; 95% CI, -1.6 to 11.8 percentage points).
• Screening rates were also similar for patients who received personalized or generic messages (36.8% vs 41.0%; difference, -4.1; 95% CI, -10.2 to 1.9 percentage points).
• In one health system, patients who received a generic message whose physician was sent a personalized notification had higher stool testing rates than those whose providers were sent generic messages (21.1% vs 7.9%; 95% CI, 1.6-24.8 percentage points).
• Colonoscopy completion rates were lower for people who received a personalized decision aid than those who received a generic version (15.8% vs 21.1%; 95% CI, -10.2 to -0.4 percentage points; P = .035).

IN PRACTICE:

“Some may think that reducing uptake of colonoscopy is not desirable given the goal of increasing uptake of CRC screening,” the study authors wrote. “A change in test choice from colonoscopy to stool testing, however, could help reduce the high reliance and burden on endoscopic resources and resultant expense for healthcare systems. Such a change would be most efficacious if it involved low-risk patients.”

SOURCE:

This study was led by Peter H. Schwartz, MD, PhD, of the Indiana University Center for Bioethics in Indianapolis. It was published online in Annals of Internal Medicine.

LIMITATIONS:

This study was conducted in two healthcare systems in one metropolitan area in the Midwest with few Hispanic and Asian patients. Only a small number of participants were at high risk for developing ACN, which limited the evaluation of personalized messages.

DISCLOSURES:

One study author reported receiving a grant from Exact Sciences outside the submitted work. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.