Direct mailing of faecal occult blood tests for colorectal cancer screening: A randomized population study from central Italy

Paolo Giorgi Rossi, Grazia Grazzini, Marcello Anti, Diego Baiocchi, Alessandra Barca, Paola Bellardini, Silvia Brezzi, Laura Camilloni, Patrizia Falini, Vincenzo Maccallini, Paola Mantellini, Daniele Romeo, Tiziana Rubeca, Maria Antonietta Venditti

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Sending faecal occult blood tests (FOBT) by mail has been proposed both as a method to increase participation and a way to reduce staff costs in colorectal cancer screening. Methods: Two multicentre randomized controlled trials (ISRCTN10351276) were performed: one randomly assigned 3196 individuals who had previously participated in colorectal screening to receive a FOBT kit at home or a standard invitation; in the second, 4219 people aged 50-69 years who did not respond to a screening invitation were either sent a FOBT or a standard recall letter. The cost per returned kit was calculated in each arm. Results: Participation was higher with direct FOBT mailing in both trials: relative risk 1.11 (95% CI 1.06-1.17) and 1.36 (95% CI 1.16-1.60) for previous responders and non-responders, respectively. The cost per returned kit for previous responders ranged from 4.24€ to 16.10€, and from 3.29€ to 7.36€ with FOBT mailing and standard invitation, respectively, not including staff costs; for non-responders it ranged from 17.13€ to 46.80€, and from 7.36€ to 18.30€ with FOBT mailing and standard recall, respectively. Conclusions The FOBT mailing strategy modestly increased participation. This method can be used on a population of previous responders to reduce personnel costs and workload. When used as a reminder to non-responders, this method increases costs.

Original languageEnglish
Pages (from-to)121-127
Number of pages7
JournalJournal of Medical Screening
Volume18
Issue number3
DOIs
Publication statusPublished - Sep 2011

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Occult Blood
Hematologic Tests
Early Detection of Cancer
Italy
Colorectal Neoplasms
Costs and Cost Analysis
Population
Postal Service
Workload
Randomized Controlled Trials

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

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Direct mailing of faecal occult blood tests for colorectal cancer screening : A randomized population study from central Italy. / Rossi, Paolo Giorgi; Grazzini, Grazia; Anti, Marcello; Baiocchi, Diego; Barca, Alessandra; Bellardini, Paola; Brezzi, Silvia; Camilloni, Laura; Falini, Patrizia; Maccallini, Vincenzo; Mantellini, Paola; Romeo, Daniele; Rubeca, Tiziana; Venditti, Maria Antonietta.

In: Journal of Medical Screening, Vol. 18, No. 3, 09.2011, p. 121-127.

Research output: Contribution to journalArticle

Rossi, PG, Grazzini, G, Anti, M, Baiocchi, D, Barca, A, Bellardini, P, Brezzi, S, Camilloni, L, Falini, P, Maccallini, V, Mantellini, P, Romeo, D, Rubeca, T & Venditti, MA 2011, 'Direct mailing of faecal occult blood tests for colorectal cancer screening: A randomized population study from central Italy', Journal of Medical Screening, vol. 18, no. 3, pp. 121-127. https://doi.org/10.1258/jms.2011.011009
Rossi, Paolo Giorgi ; Grazzini, Grazia ; Anti, Marcello ; Baiocchi, Diego ; Barca, Alessandra ; Bellardini, Paola ; Brezzi, Silvia ; Camilloni, Laura ; Falini, Patrizia ; Maccallini, Vincenzo ; Mantellini, Paola ; Romeo, Daniele ; Rubeca, Tiziana ; Venditti, Maria Antonietta. / Direct mailing of faecal occult blood tests for colorectal cancer screening : A randomized population study from central Italy. In: Journal of Medical Screening. 2011 ; Vol. 18, No. 3. pp. 121-127.
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AU - Baiocchi, Diego

AU - Barca, Alessandra

AU - Bellardini, Paola

AU - Brezzi, Silvia

AU - Camilloni, Laura

AU - Falini, Patrizia

AU - Maccallini, Vincenzo

AU - Mantellini, Paola

AU - Romeo, Daniele

AU - Rubeca, Tiziana

AU - Venditti, Maria Antonietta

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N2 - Background: Sending faecal occult blood tests (FOBT) by mail has been proposed both as a method to increase participation and a way to reduce staff costs in colorectal cancer screening. Methods: Two multicentre randomized controlled trials (ISRCTN10351276) were performed: one randomly assigned 3196 individuals who had previously participated in colorectal screening to receive a FOBT kit at home or a standard invitation; in the second, 4219 people aged 50-69 years who did not respond to a screening invitation were either sent a FOBT or a standard recall letter. The cost per returned kit was calculated in each arm. Results: Participation was higher with direct FOBT mailing in both trials: relative risk 1.11 (95% CI 1.06-1.17) and 1.36 (95% CI 1.16-1.60) for previous responders and non-responders, respectively. The cost per returned kit for previous responders ranged from 4.24€ to 16.10€, and from 3.29€ to 7.36€ with FOBT mailing and standard invitation, respectively, not including staff costs; for non-responders it ranged from 17.13€ to 46.80€, and from 7.36€ to 18.30€ with FOBT mailing and standard recall, respectively. Conclusions The FOBT mailing strategy modestly increased participation. This method can be used on a population of previous responders to reduce personnel costs and workload. When used as a reminder to non-responders, this method increases costs.

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