Educating people about colon cancer screening using videos and brochures increases the ordering and completion of screening tests
- Savides, Thomas J. MD
BACKGROUND
Although colon cancer screening is recommended for over 50 year olds in the United States, actual screening rates are low. Interventions targeting providers have some success, but few focus on informing patients of the availability and need for different screening options.
OBJECTIVE
To examine the impact of a patient focused video and brochure on primary care colon cancer screening.
SETTING
North Carolina, USA; three primary care practices; May-November 1998.
METHOD
Randomised controlled trial.
LITERATURE REVIEW
No explicit strategy, 25 references.
PARTICIPANTS
Two hundred and forty-nine 50-75 year olds with no family or personal history of colon cancer. Those who had faecal occult blood testing in the past year or flexible sigmoidoscopy, colonoscopy or barium enemas in the past 5 years were ineligible.
INTERVENTION
Participants were randomised to view an 11-minute video about road safety or colon cancer screening. The screening group then chose a colour-coded brochure indicating their level of interest in screening and a corresponding chart marker was attached to their records. The control group received a general road safety brochure.
OUTCOMES
Screening test frequency and completion (self-report and chart review).
MAIN RESULTS
After watching the video the intervention group had a higher average intention of requesting screening and of discussing screening with their physician (P < 0.05). 26% of the control group and 47% of the intervention group had flexible sigmoidoscopy or faecal occult blood testing ordered (P < 0.05). A blinded chart review after 3-6 months showed that tests were completed for 23% of the control and 37% of the intervention group (P < 0.05).
AUTHORS' CONCLUSIONS
The video, brochure and chart marker system was associated with increased ordering and completion of colon cancer screening. About seven people would need to use the video and brochure system for one additional person to complete screening.
NOTE
Practitioners were not blinded since a chart marker system was used. This means that conclusions cannot be drawn about whether the chart markers or video/brochure schemes were most effective.