Call can boost cancer screening in minorities

NEW YORK (Reuters Health) - Telephone outreach is an effective way to increase colorectal cancer screening rates among men and women in a predominantly African American urban minority population, a new study shows.

Twenty-seven percent of individuals contacted by telephone went for a screening test within six months, compared with 6.1 percent of those who only received information in the mail, Dr. Charles E. Basch of Columbia University in New York City and colleagues found.

This meant people in the phone program were more than four times as likely to undergo screening, a "dramatic" effect, Basch and his team state.

African Americans are at greater risk of colorectal cancer than any other US ethnic group and are more likely to die from the disease, the researchers point out in their paper, published in the American Journal of Public Health. But rates of colon cancer screening are lowest among low-income and minority populations, they add.

While telephone interventions have been shown to increase screening rates for several types of cancer, Basch and colleagues point out, all studies to date have been conducted in predominantly white populations.

To investigate if this approach is effective in a minority population as well, the researchers developed a telephone outreach program and tested its effectiveness among members of a health benefit fund living in the New York City area. Most of the 456 study participants were African American, all were older than 52, and none had recently undergone colorectal cancer screening. All had health insurance that covered the screening test.

The telephone outreach program consisted of "tailored telephone education," with counselors addressing participants' misconceptions about colorectal cancer screening, providing social and emotional support, and ultimately getting participants to verbally commit to undergo screening. Participants received five calls, on average, totaling 23.5 minutes.

Members of the control group received information on colorectal cancer and screening tests through the mail.

Six months after the outreach program was completed, 27 percent of the 226 phone program participants had undergone a verified colorectal cancer screening test, while just 6.1 percent of the 230 control group participants had.

Despite the effectiveness of the telephone outreach program, Basch and colleagues note, most of the people in the group still did not undergo screening within six months.

Additional research is needed to find low-cost methods of increasing colorectal cancer screening, especially in African-American black populations that are increased risk for colorectal cancer mortality, the researchers conclude.

SOURCE: American Journal of Public Health, December 2006.