The objective of this pilot study is to compare the effectiveness of mailed outreach of two stool based tests, Cologuard and the fecal immunochemical test (FIT) in screening eligible adults ages 45-49 receiving care at the University of California San Diego Health system.
Adults ages 45-49 who are insured, deemed average risk and not currently up to date with colorectal cancer screening will be enrolled. Eligible participants will be randomized to either mailed Cologuard outreach, facilitated by Exact Sciences or mailed FIT outreach. Colorectal cancer screening completion within 3 months will be measured as the primary outcome, in addition to secondary recruitment and intervention-based feasibility outcomes to demonstrate the potential for a larger randomized controlled trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
100
Multi-target stool DNA test for colorectal cancer screening implemented by Exact Sciences. Cologuard has 94% sensitivity and 87% specificity to detect colorectal cancer.
Stool blood test for colorectal cancer screening. FIT has 75% sensitivity and 90% specificity to detect colorectal cancer.
University of California San Diego
La Jolla, California, United States
Proportion of Colorectal cancer screening completion
The proportion of individuals who complete any colorectal cancer screening test recommended by US Preventive Services Task Force (colonoscopy, FIT, Cologuard, Sigmoidoscopy or CT Colonography)
Time frame: Within 3 months of randomization
Proportion of Abnormal stool blood test results
Among those completing designed interventions (Cologuard or FIT), the proportion of test results yielding an abnormal result.
Time frame: Within 3 months of randomization
Proportion of Follow-up colonoscopy after abnormal stool blood test result
Among those with positive stool blood test results, the proportion who complete diagnostic follow-up colonoscopy
Time frame: Within 6 months after stool blood test completion
Number of participants opting out of the pilot
Measurement of feasibility of pilot
Time frame: Within 3 months of randomization
Number of participants with undeliverable FIT or Cologuard tests (mail fail rate)
Measurement of feasibility of mailed outreach
Time frame: Within 3 months of randomization
Number of Adenomas detected
Measurement of number of adenomas detected during study period
Time frame: Within 6 months after screening test completion
Number of sessile serrated lesions detected
Measurement of number of sessile serrated lesions detected during study period
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Time frame: Within 6 months after screening test completion
Number of colorectal cancer cases detected
Number of colorectal cancers detected during study period
Time frame: Within 6 months after screening test completion