Impact of a Doctor's Invitation on Participation in Colorectal Cancer Screening: A Cluster Randomized Trial - 31/08/15
, Elodie Perrodeau, MSc b, Serge Gilberg, MD, PhD a, Philippe Ravaud, PhD b, Christian Ghasarossian, MD, PhD a, Françoise Marchand-Buttin, MD c, Jacques Deyra, MSc c, Hector Falcoff, MD, PhA a, dAbstract |
Background |
There is a need to improve participation in colorectal cancer screening. Our objective was to assess the impact of a signature from the patient's general practitioner on a letter inviting patients to participate in a colorectal cancer screening.
Method |
We conducted a cluster randomized controlled trial with 57 general practitioners established in Paris for more than 5 years, randomized to intervention or usual-care arms. There were 3422 patients included, ages 50-74 years, from general practitioner patient files, and eligible for an invitation letter or a reminder letter to participate in the national population-based screening program. In the intervention arm, patients received a standard letter signed by their general practitioner inviting them to visit the general practitioner's office for a fecal occult blood test if they were eligible. Control patients received the standard invitation letter or the standard reminder. All letters were sent by the district screening organization. The main outcome was the proportion of patients who took the fecal occult blood test within 6 months after the invitation.
Results |
Among patients eligible for the study, 508 (14.8%) took a fecal occult blood test after being invited; 285 (15%; 95% confidence interval [CI], 13.5-16.7) in the intervention group and 223 (14.6%; 95% CI, 12.9-16.5) in the control group, with no statistical difference between the 2 groups (odds ratio 1.04; 95% CI, 0.83-1.31; P = .731).
Conclusions |
The addition of a general practitioner's signature to a standard letter inviting patients to take a fecal occult blood test had no impact on the frequency of patients taking the fecal occult blood test in the Paris program of colorectal cancer screening.
Le texte complet de cet article est disponible en PDF.Keywords : Colonic neoplasm, General practitioner, Mass screening, Occult blood, Patient participation
Plan
| The “Comité d'Evaluation de l'Ethique des projets de Recherche Biomédicale (CEERB) du GHU Nord” Institutional Review Board of Paris North Hospitals, Paris 7 University, AP-HP (no. IRB00006477) approved the research project (JMD/MDM/437-10) (ref no. 10-065). Additional data and the full trial protocol are available on request. |
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| Funding: This study was funded by the Institut National du Cancer (InCA) (grant number: 2010-235), Boulogne Billancourt, France and the Agence Régionale de Santé, Paris, France. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. |
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| Conflict of Interest: All authors (except those working for ADECA 75) had financial support from l'Agence Régionale de Santé (ARS) and Institut National du Cancer for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work. |
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| Authorship: PR and JD had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. |
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| Study concept and design: JB, SG, PR, CG, FMB, HF. |
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| Acquisition of data: JB, SG, PR, CG, FMB, JD, HF. |
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| Analysis and interpretation of data: JB, EP, SG, PR, CG, FMB, JD, HF. |
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| Drafting of the manuscript: JB, EP, SG, PR, HF. |
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| Critical revision of the manuscript for important intellectual content: JB, EP, SG, PR, CG, FMB, JD, HF. |
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| Statistical analysis: EP, PR. |
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| Obtained funding: JB, HF. |
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| Administrative, technical, and material support: JB, SG, PR, HF. |
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| Study supervision: JB, SG, PR, HF. |
Vol 128 - N° 9
P. 1024.e1-1024.e7 - septembre 2015 Retour au numéro
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