Cost-effectiveness of a mailed educational reminder to increase colorectal cancer screening
Open Access
- 25 August 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Gastroenterology
- Vol. 11 (1), 93
- https://doi.org/10.1186/1471-230x-11-93
Abstract
Background Colorectal cancer (CRC) screening rates are low in many areas and cost-effective interventions to promote CRC screening are needed. Recently in a randomized controlled trial, a mailed educational reminder increased CRC screening rates by 16.2% among U.S. Veterans. The aim of our study was to assess the costs and cost-effectiveness of a mailed educational reminder on fecal occult blood test (FOBT) adherence. Methods In a blinded, randomized, controlled trial, 769 patients were randomly assigned to the usual care group (FOBT alone, n = 382) or the intervention group (FOBT plus a mailed reminder, n = 387). Ten days after picking up the FOBT cards, a 1-page reminder with information related to CRC screening was mailed to the intervention group. Primary outcome was number of returned FOBT cards after 6 months. The costs and incremental cost-effectiveness ratio (ICER) of the intervention were assessed and calculated respectively. Sensitivity analyses were based on varying costs of labor and supplies. Results At 6 months after card distribution, 64.6% patients in the intervention group returned FOBT cards compared with 48.4% in the control group (P < 0.001). The total cost of the intervention was $962 or $2.49 per patient, and the ICER was $15 per additional person screened for CRC. Sensitivity analysis based on a 10% cost variation was $13.50 to $16.50 per additional patient screened for CRC. Conclusions A simple mailed educational reminder increases FOBT card return rate at a cost many health care systems can afford. Compared to other patient-directed interventions (telephone, letters from physicians, mailed reminders) for CRC screening, our intervention was more effective and cost-effective.Keywords
This publication has 28 references indexed in Scilit:
- Improving Fecal Occult Blood Testing Compliance Using a Mailed Educational ReminderJournal of General Internal Medicine, 2009
- The uptake and effect of a mailed multi-modal colon cancer screening intervention: A pilot controlled trialImplementation Science, 2008
- Cost‐effectiveness of targeted and tailored interventions on colorectal cancer screening useCancer, 2008
- A Quantitative Immunochemical Fecal Occult Blood Test for Colorectal NeoplasiaAnnals of Internal Medicine, 2007
- Effect of a Mailed Brochure on Appointment-Keeping for Screening ColonoscopyAnnals of Internal Medicine, 2006
- A Cost-Effectiveness Comparison of Three Tailored Interventions to Increase Mammography ScreeningJournal of Women's Health, 2004
- Randomised controlled trial of faecal-occult-blood screening for colorectal cancerThe Lancet, 1996
- Implementation Issues and Costs Associated with a Proven Strategy for Increasing Breast and Cervical Cancer Screening Among Low-Income WomenJournal of Public Health Management & Practice, 1996
- Incorporating Practice Costs Into the Resource-Based Relative Value ScaleMedical Care, 1992
- A mass screening program for colorectal cancer using chemical testing for occult blood in the stoolCancer, 1980