Intervention increases colorectal cancer screening, especially in low literacy veterans

Gorby NS, Ferreira MR, Dolan N, Fitzgibbon M, Davis T, Liu D, Rademaker AW, Bennett CL. Intervention increases colorectal cancer screening, especially in low literacy veterans. Paper presented at: VA QUERI National Meeting; 2003 Dec 1; Washington, DC.

Objectives: This study examined whether a combined patient and physician intervention increased adherence to colorectal cancer (CRC) screening. Methods: A randomized controlled intervention was conducted with outpatients at VA Chicago-Lakeside Division. One firm, with 979 patients, was assigned to the intervention, and the other, with 941 patients, to usual care. The patient intervention, involving an educational brochure and video included male Veterans, age 50 and older, who had not undergone recent CRC screening. Literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). The physician component included quarterly anonymous 'report cards' indicating screening recommendation and adherence rates. Results: Patient mean age was 67.8 years. 44% were white and 50% were African-American. After 6-12 months of follow-up, a higher rate of screening recommendations was observed in the intervenention arm compared to the control arm (76% vs. 70%, p = 0.038), as well as a higher rate for completed screening tests (41% vs. 33%, p = 0.008). The intervention had a greater effect on the rate of completed screening tests among low-literate patients (55.8% vs. 32.1%, p = 0.007- low literacy group; 40.2% vs. 37.2%, p = 0.67- high literacy group). Implications: This intervention significantly increased screening recommendations and adherence to CRC screening among Veterans, especially persons with poor literacy skills. Interventions that increase adherence to colorectal cancer screening may improve veterans' outcomes by reducing colorectal cancer-related mortality.