Folasade May, MD, on Strategies to Maximize Colorectal Cancer Screening

Dr May recaps a late-breaking abstract from Digestive Disease Week 2023 reporting results from a randomized trial her team conducted to determine the best strategies for increasing rates of screening for colorectal cancer among unscreened people aged 45 to 49.

Folasade May, MD, is an assistant professor at the David Geffen School of Medicine and an associate airector of the UCLA Kaiser Permanente Center for Health Equity at the University of California Los Angeles.

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Hi, my name is Fola May. I'm a gastroenterologist and researcher at UCLA Health.

We are very excited because we just presented the results of our late breaking abstract here at DDW. The presentation was given by Dr. Artin Galoosian, who's a fellow in our lab. He did a wonderful job explaining that we conducted a randomized, controlled trial in our health system, which is UCLA Health.

This trial included 20,000 patients who were between the ages of 45 and 49 who were unscreened for colorectal cancer. And we really asked ourselves, which strategy is best to screen these patients? Where can we get the highest completion of colorectal cancer screening? These 20,000 patients were randomized to four conditions. Some of them were given an invitation to do FIT testing. That was an opt in. There was a group two that was given an invitation to participate in colonoscopy. There was a third group that was given a choice between FIT or colonoscopy. And there was a fourth group that was sent a default FIT kit. They didn't have to opt in or make a choice. It was sent to them in the mail.

And we found that the group that received the default FIT kit had the highest completion of colorectal cancer screening at about 26% completion compared to the lowest group of completion, which was the colonoscopy invitation group. In that group, about 15% of the population completed the screening. So we love this study because it's important for us to understand strategies that are going to work best in individuals age 45 to 49 who are newly eligible for colorectal cancer screening.

And we're learning that some of our strategies that are tried and true may work for this group as well. But we also learned in this study that there was considerable interest in colonoscopy because even in the groups of people who were invited to do FIT, some of them asked if they could do a colonoscopy instead. So I think this group was going to be eager about getting screened, they just need to be aware that they're eligible for screening and that things like mailed FIT might be very effective for this population.

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