A Randomized Controlled Trial of Opt-in Versus Opt-Out Colorectal Cancer Screening Outreach

Am J Gastroenterol. 2018 Dec;113(12):1848-1854. doi: 10.1038/s41395-018-0151-3.

Abstract

Objectives: METHODS:: RESULTS:: Patients randomized to opt-in agreed to participate 23.1% of the time, and only 2.5% of those in opt-out chose not to participate. FIT kits were mailed to 22.4% and 93% of patients in opt-in and opt-out arms, respectively. In intention-to-screen analysis, patients in the opt-out arm had a higher FIT completion rate (29.1%) than in the opt-in arm (9.6%) (absolute difference 19.5%; 95% confidence interval, 10.9-27.9%; P < .001). Results were similar in subgroup analysis of those sent initial messaging through the EHR portal (9.5% opt-in versus 37.5% in opt-out).

Publication types

  • Comparative Study
  • Pragmatic Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Colorectal Neoplasms / diagnosis*
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / psychology
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Humans
  • Immunologic Tests / methods
  • Immunologic Tests / psychology
  • Immunologic Tests / statistics & numerical data
  • Male
  • Mass Screening / methods
  • Mass Screening / organization & administration*
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Occult Blood
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Refusal to Participate / statistics & numerical data*