Text messaging as a tool to improve cancer screening programs (M-TICS Study): A randomized controlled trial protocol

PLoS One. 2021 Jan 22;16(1):e0245806. doi: 10.1371/journal.pone.0245806. eCollection 2021.


Background: Short message service (SMS) based interventions are widely used in healthcare and have shown promising results to improve cancer screening programs. However, more research is still needed to implement SMS in the screening process. We present a study protocol to assess the impact on health and economics of three targeted SMS-based interventions in population-based cancer screening programs.

Methods/design: The M-TICs study is a randomized controlled trial with a formal process evaluation. Participants aged 50-69 years identified as eligible from the colorectal cancer (CRC) and breast cancer (BC) screening program of the Catalan Institute of Oncology (Catalonia, Spain) will be randomly assigned to receive standard invitation procedure (control group) or SMS-based intervention to promote participation. Two interventions will be conducted in the CRC screening program: 1) Screening invitation reminder: Those who do not participate in the CRC screening within 6 weeks of invite will receive a reminder (SMS or letter); 2) Reminder to complete and return fecal immunochemical test (FIT) kit: SMS reminder versus no intervention to individuals who have picked up a FIT kit at the pharmacy and they have not returned it after 14 days. The third intervention will be performed in the BC screening program. Women who had been screened previously will receive an SMS invitation or a letter invitation to participate in the screening. As a primary objective we will assess the impact on participation for each intervention. The secondary objectives will be to analyze the cost-effectiveness of the interventions and to assess participants' perceptions.

Expected results: The results from this randomized controlled trial will provide important empirical evidence for the use of mobile phone technology as a tool for improving population-based cancer screening programs. These results may influence the cancer screening invitation procedure in future routine practice.

Trial registration: Registry: NCT04343950 (04/09/2020); clinicaltrials.gov.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Breast Neoplasms / diagnosis*
  • Colorectal Neoplasms / diagnosis*
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Text Messaging*

Associated data

  • ClinicalTrials.gov/NCT04343950

Grants and funding

This study was partially cofounded by Instituto de Salud Carlos III (ISCIII)-Subdirección General de Evaluación and by FEDER funds/European Regional Development Fund (ERDF)—a way to build Europe (PI19/00226) and by the Department of Universities and Research (2017 SGR 1283) of the Government of Catalonia. The funders will not participate in the study design; collection, management, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication.