Financial Incentives to Promote Colorectal Cancer Screening: A Longitudinal Randomized Control Trial

Lieberman, Alicea; Gneezy, Ayelet; Berry, Emily; Miller, Stacie; Koch, Mark; Ahn, Chul; Balasubramanian, Bijal A.; Argenbright, Keith; Gupta, Samir

doi:10.1158/1055-9965.epi-19-0039

Cited by 13 publications

(16 citation statements)

References 31 publications

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“…The literature in this area is evolving, as currently available randomized trials have had mixed results. [74][75][76][77] Future research is likely to clarify whether and how financial incentives may augment FIT completion in response to mailed outreach. We did not include a formal key question focused on the cost-effectiveness of patient navigation for abnormal FIT follow-up; however, evidence regarding the costeffectiveness of patient navigation across the cancer continuum for multiple cancers recently has been summarized.…”

Section: Limitationsmentioning

confidence: 99%

Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored Summit

Gupta

Coronado

Argenbright

et al. 2020

CA A Cancer J Clinicians

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Uptake of colorectal cancer screening remains suboptimal. Mailed fecal immunochemical testing (FIT) offers promise for increasing screening rates, but optimal strategies for implementation have not been well synthesized. In June 2019, the Centers for Disease Control and Prevention convened a meeting of subject matter experts and stakeholders to answer key questions regarding mailed FIT implementation in the United States. Points of agreement included: 1) primers, such as texts, telephone calls, and printed mailings before mailed FIT, appear to contribute to effectiveness; 2) invitation letters should be brief and easy to read, and the signatory should be tailored based on setting; 3) instructions for FIT completion should be simple and address challenges that may lead to failed laboratory processing, such as notation of collection date; 4) reminders delivered to initial noncompleters should be used to increase the FIT return rate; 5) data infrastructure should identify eligible patients and track each step in the outreach process, from primer delivery through abnormal FIT follow‐up; 6) protocols and procedures such as navigation should be in place to promote colonoscopy after abnormal FIT; 7) a high‐quality, 1‐sample FIT should be used; 8) sustainability requires a program champion and organizational support for the work, including sufficient funding and external policies (such as quality reporting requirements) to drive commitment to program investment; and 9) the cost effectiveness of mailed FIT has been established. Participants concluded that mailed FIT is an effective and efficient strategy with great potential for increasing colorectal cancer screening in diverse health care settings if more widely implemented.

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Section: Limitationsmentioning

confidence: 99%

Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored Summit

Gupta

Coronado

Argenbright

et al. 2020

CA A Cancer J Clinicians

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“…31 , 32 This is concordant with socialized healthcare systems, as in the United Kingdom, where screening rates remain low. 33 The limited effect of financial incentives to increase cancer screening rates 34 , 35 is indicative of the greater role that other factors play in encouraging cancer screening. A larger impact could be achieved by tackling these other concerns, many of which can be alleviated through the clear, concise and thoughtful delivery of information.…”

Section: Discussionmentioning

confidence: 99%

Afterthoughts on colonoscopy. Was it that bad?

Decruz

Lim

et al. 2020

J Med Screen

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Objectives Colorectal cancer is among the top three most common cancers globally. In order to reduce the health burden, it is important to improve the uptake of colorectal cancer screening by understanding the barriers and facilitators encountered. There are numerous reports in the literature on the views of the general public on cancer screening. However, the experiences of colonoscopy patients are not as well studied. This paper maps their perceptions. Methods Keyword searches for terms such as ‘colorectal’, ‘colonoscopy’ and ‘qualitative’ were conducted on 3 December 2019 in five databases: Medline, Embase, CINAHL, PsycINFO and Web of Science Core Collection. Qualitative articles that quoted colonoscopy-experienced patients with no prior history of colorectal cancer were included for the thematic analysis. The systematic review was then synthesized according to PRISMA guidelines. Results The major themes were distilled into three categories: pre-procedure, during and post-procedure. The factors identified in the pre-procedure phase include the troublesome bowel preparation, poor quality of information provided and the dynamics within a support network. Perceptions of pain, emotional discomfort and the role of providers mark the experience during the procedure. The receipt of results, opportunities given for discussion and finances relating to colonoscopy are important post-procedure events. Conclusion Understanding colorectal cancer screening behaviour is fundamental for healthcare providers and authorities to develop system and personal level changes for the improvement of colorectal cancer screening services. The key areas include patient comfort, the use of clearer instructional aids and graphics, establishing good patient rapport, and the availability of individualized options for sedation and the procedure.

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“…18 A similar study demonstrated that the addition of $5 or $10 incentive to a mailed FIT failed to increase screening completion for any of the 3 years of the study duration. 19 Other studies highlight the potential for increased adherence using financial incentives. A 1 in 10 chance of receiving $50 increased rates of FBT completion but a $5 fixed payment, or entry into a raffle for $500, did not.…”

Section: Interventions To Increase Crc Screeningmentioning

confidence: 99%

What Multilevel Interventions Do We Need to Increase the Colorectal Cancer Screening Rate to 80%?

Inadomi

Issaka

Green

2021

Clinical Gastroenterology and Hepatology

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Screening reduces colorectal cancer mortality; however, this remains the second leading cause of cancer deaths in the United States and adherence to colorectal cancer screening falls far short of the National Colorectal Cancer Roundtable goal of 80%. Numerous studies have examined the effectiveness of interventions to increase colorectal cancer screening uptake. Outreach is the active dissemination of screening outside of the primary care setting, such as mailing fecal blood tests to individuals' homes. Navigation uses trained personnel to assist individuals through the screening process. Patient education may take the form of brochures, videos, or websites. Provider education can include feedback about screening rates of patient panels. Reminders to healthcare providers can be provided by dashboards of patients due for screening. Financial incentives provide monetary compensation to individuals when they complete screening tests, either as fixed payments or via a lottery. Individual preference for specific screening strategies has also been examined in several trials, with a choice of screening strategies yielding higher adherence than recommendation of a single strategy.

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Financial Incentives to Promote Colorectal Cancer Screening: A Longitudinal Randomized Control Trial

Cited by 13 publications

References 31 publications

Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored Summit

Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored Summit

Afterthoughts on colonoscopy. Was it that bad?

What Multilevel Interventions Do We Need to Increase the Colorectal Cancer Screening Rate to 80%?

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