Automated Calls Increase Colon Cancer Screenings

Janice Simmons, July 6, 2010

At least 30% more people were encouraged to get screenings for colon cancer following automated phone reminders, according to a Kaiser Permanente Center for Health Research study funded by the National Cancer Institute.

The study -- the first to examine whether automated calls can increase screenings for colon cancer -- involved nearly 6,000 Kaiser Permanente members in Oregon and Washington who were overdue for screenings. .

Half of the group received automated calls stressing the importance of screening and offering them free at home test kits. If they failed to respond to that first call, a follow-up call -- accompanied by a second call, if necessary -- would be placed during six-week intervals. Results of the study appear in the July issue of Medical Care.

Within six months, 22.5% of individuals who received reminder calls ordered and completed a stool card test, compared with only 16% of those who did not receive reminder calls, according to David Mosen, PhD, MPH, an investigator at the Kaiser Permanente Center for Health Research in Portland, OR. "We think this is pretty significant given that this is a pretty challenging group to get in [for a screening]. They were overdue," he says.

"We were very encouraged by the results. Colon cancer is one of those cancers that are preventable if the screening is done regularly, so I think it's a very worthwhile thing to do," Mosen says.

Several screening methods for colon cancer, the second leading cause of cancer death in the United States, are available, including: a colonoscopy, a sigmoidoscopy, and the fecal occult blood test (a non invasive test to detect blood in the stool). FOBT--the test used in this study -- has often been recommended as a first step for screening, and requires people to place stool samples on cards that are mailed to a lab.

While the stool test is easy to take, many often see it as unpleasant, according to Adrianne Feldstein, MD, the study?s principal author and a researcher at the Center for Health Research. "This study shows that simple, automated calls motivate more people to take the test," says Feldstein.

In the study, people ages 51 to 80 received calls because they had not had a colonoscopy in the last 10 years, a flexible sigmoidoscopy or barium enema in the last five years, an FOBT test in the past 12 months, or a clinician referral for FOBT or barium enema within the last three months.

The automated calls, recorded in English and Spanish, are about one minute long and cost less than $1 a call on average, according to Mosen.

After reviewing the results of the study, conducted in 2008, Kaiser Permanente in Oregon and Washington decided to use the automated phone calls to remind all its members who are overdue for colon cancer screening.

Janice Simmons Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at
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