SCORE
Trial question
What is the role of centralized CRC screening outreach in patients at average risk for CRC?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
56.0% female
44.0% male
N = 4002
4002 patients (2256 female, 1746 male).
Inclusion criteria: adults, aged 50-75 years at average risk for CRC and due for CRC screening.
Key exclusion criteria: IBD; personal or family history of CRC; major comorbidities.
Interventions
N=2001 centralized cancer screening (centralized fecal immunochemical testing by mail with patient navigation to schedule colonoscopy if needed).
N=2001 usual care (usual care alone including opportunistic visit-based CRC screening).
Primary outcome
Rate of completion of colorectal cancer screening within 6 months
30%
9.7%
30.0 %
22.5 %
15.0 %
7.5 %
0.0 %
Centralized cancer
screening
Usual
care
Significant
increase ▲
NNT = 4
Significant increase in the rate of completion of CRC screening within 6 months (30% vs. 9.7%; AD 20.3%, 95% CI 17.9 to 22.7).
Secondary outcomes
No significant difference in the rate of completion of colonoscopy within 6 months of an abnormal fecal immunochemical testing (68.8% vs. 44.4%; AD 24.3%, 95% CI -2.13 to 50.74).
Significant increase in the rate of detection of advanced colorectal neoplasia within 12 months of randomization (1.4% vs. 0.7%; AD 0.68%, 95% CI 0.05 to 1.35).
Significant increase in CRC screening completion rates at 12 months (34.6% vs. 16.6%; AD 17.99%, 99% CI 15.3 to 20.69).
Conclusion
In adults, aged 50-75 years at average risk for CRC and due for CRC screening, centralized cancer screening was superior to usual care with respect to the rate of completion of CRC screening within 6 months.
Reference
Daniel S Reuland, Meghan C O'Leary, Seth D Crockett et al. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers: A Randomized Clinical Trial. JAMA Netw Open. 2024 Nov 4;7(11):e2446693.
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