Texting May Help Reduce Disparities in Colorectal Cancer Screening
, by NCI Staff
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Text message–based outreach is being used alongside other tools to try to reduce racial/ethnic disparities in screening for colorectal cancer.
Text messaging isn’t just for finding fun ways to use new emojis and having disjointed digital conversations with friends. According to results from a new study, combining text messaging with mailing people free, at-home test kits can help boost the number of people who get screened for colorectal cancer.
The findings come from a clinical trial of more than 400 people who had been patients at a community health center in southwest Philadelphia. Approximately 90% of the people involved in the study were Black, in whom screening rates have traditionally been low.
Among those in the study who received a single text message reminding them that they were overdue for colorectal cancer screening, only about 2% got screened in the next 12 weeks. But among those who were sent a series of text messages about getting screened and were mailed a fecal immunochemical test (FIT) to use at home, approximately 20% completed the test and returned it by mail over the same time period—a nearly 10-fold increase in screening completion.
The results were published January 28 in the Journal of General Internal Medicine.
The number of people who completed the screening is still relatively low, acknowledged one of the trial’s lead investigators, Shivan Mehta, M.D., of the Perelman School of Medicine at the University of Pennsylvania. But the study’s results are promising nonetheless, Dr. Mehta said.
“The patient population for this study is a historically underserved population: 50% are on Medicaid and many are uninsured. For a variety of reasons, they’re not getting screened for colorectal cancer,” he said.
Paul Doria-Rose, Ph.D., of the Healthcare Delivery Research Program in NCI’s Division of Cancer Control and Population Sciences, agreed the study shows that text messaging has a role in addressing screening disparities. It also highlights several advantages of text messaging, he said.
“Texts are much more likely to be opened than emails and are cheap and easy for health systems to implement,” Dr. Doria-Rose continued. A challenge will be how best to use text message–based outreach as a tool to address health-related disparities, whether it’s reminders about vaccinations or other preventive care.
Inundating patients with text messages, Dr. Doria-Rose warned, could “cause them to disengage from further interaction with the health care system.”