New research published in the American Cancer Society’s CANCER says that improving screening rates for colorectal cancer could be implemented in a cost-effective manner via screening kits sent through the mail to Medicaid enrollees.
While current medical standards recommend that adults ages 50-75 undergo screening for colorectal cancer by way of colonoscopies and at-home stool testing, over 33% of Americans within that age range do not comply with these recommendations. To make matters easier and more convenient, researchers have considered several methods to improve screening rates, including mailing screening reminders and mailing fecal immunochemical test (FIT) kits.
"By investing in sending the test kits with the reminder letters, health departments are expected to successfully screen more individuals for colorectal cancer at relatively low incremental costs, and Medicaid organizations are expected to actually save costs per additional person screened," said Dr. Wheeler. "This analysis provides strong evidence that health departments and payers like Medicaid can substantially improve colorectal cancer screening in low-income and medically underserved populations at a reasonable cost, even given limited budgets, through the implementation of mailed FIT programs."
Colorectal cancer is one of the most commonly diagnosed cancers, and medically underserved populations are more likely to die from colorectal cancer than other groups, according to Dr. Wheeler.
Given the limitations that the pandemic has put on in-person encounters, this mailing system could be just the answer we need, says Alison Brenner, PhD, MPH. "Many aspects of preventive health care have moved to virtual delivery or mailed outreach delivery for the time being, and it is quite likely that some of these services will never fully return to in-person, visit-based delivery," said Dr. Brenner. "Decision-makers critically need guidance on how to allocate resources for virtual or mailed outreach care delivery."
The authors conclude, writing, “The reminder + FIT alternative was cost-saving per additional Medicaid enrollee screened compared with the reminder‐only alternative from the Medicaid/state perspective and likely cost‐effective from the health clinic/facility perspective. The results also demonstrate that health departments and state Medicaid programs can efficiently mail FIT kits to large numbers of Medicaid enrollees to increase CRC screening completion.”