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Impact of a Mailed Educational Reminder on Fecal Occult Blood Testing (FOBT): A Randomized Controlled Trial

50 Years
Open (Enrolling)
Colon Cancer

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Trial Information

Impact of a Mailed Educational Reminder on Fecal Occult Blood Testing (FOBT): A Randomized Controlled Trial

Colorectal cancer (CRC) is the third most common cancer in men and women in the United
States with an estimated 147,000 new cases and more than 56,000 deaths each year. Early
detection of colon cancer and removal of precancerous adenomatous polyps have been shown to
reduce its morbidity, mortality and incidence. There are several recommended CRC screening
tests, including fecal occult blood test (FOBT), flexible sigmoidoscopy, air-contrast barium
enema, and colonoscopy. In the VA, FOBT is the predominant screening test for CRC, however
patient compliance is low. Numerous studies have evaluated patient participation in CRC
screening programs and FOBT card return rates, all of which have shown patient adherence was
suboptimal. To date, there are no studies that have evaluated whether mailed educational
reminders can improve FOBT compliance. The purpose of our randomized controlled trial is to
determine whether mailed educational reminders would increase FOBT card return rates and,
therefore, improve patient compliance with CRC screening.

Inclusion Criteria:

- asymptomatic men and women age 50 years or older who received screening FOBT card
kits from the laboratory

Exclusion Criteria:

- are less than 50 years of age

- are inpatients

- are not undergoing routine colon cancer screening

Type of Study:


Study Design:

Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Screening

Outcome Measure:

Our primary outcome is FOBT card return rate

Outcome Time Frame:

6 months

Principal Investigator

Samuel B Ho, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

UCSD, VA San Diego


United States: Institutional Review Board

Study ID:




Start Date:

June 2007

Completion Date:

October 2007

Related Keywords:

  • Colon Cancer
  • colon cancer screening
  • mail reminders
  • fecal occult blood test
  • compliance
  • Colonic Neoplasms



Veteran Affairs Medical Center San Diego San Diego, California  92161