You’ve Got Mail – Get Screened for Colon Cancer!

Earlier this week, the Journal of the American Medicine Association (JAMA) Internal Medicine reported that according to a Texas study, mailings encouraging colorectal cancer (CRC) screening proved to be effective among underserved patients. Dr. Samir Gupta of the University of Texas Southwestern Medical Center served as the investigator. Polymedco, producer of the FIT test collaborated on the study.

The study targeted uninsured patients ages 54-64 years old who were not up-to-date with CRC screening and enrolled in a program for those with limited or no access to health care. Two separate mailings, as well as a follow-up reminder phone call, offered patients one of the following:

#1 –  A FIT test (fecal immunochemical test) where patients were to follow instructions to submit a stool sample and return the kit at no-cost to them.

#2 – A mailed invitation encouraging patients to schedule a FREE colonoscopy.

(A third group received standard care where doctors recommended screening during face-to-face primary care visits.)

The study results showed that compared to the group who received face-to-face encouragement, the patients who received mailings were more likely to undergo CRC screening. Additionally, the FIT mailings had the higher response rate compared to the free colonoscopy offers.

Insights into Colorectal Cancer Screening

The study has created buzz in the colorectal cancer community not only about the importance of options when it comes to CRC screening, but the ways to reach the underserved and uninsured populations.

As colorectal cancer patients, survivors and caregivers who share stories to prompt CRC screening, the study offers a few insights on what might prove to be effective in certain situations as we advocate:

1. Encourage Screening Options

The study presented two options for screening:  the free FIT test and instructions for a free colonoscopy. And the FIT test proved to have a higher response rate. It’s important to not forget there are several screening methods available for colorectal cancer.

Want to know more about your screening options?

2. People Like Confidentiality

It doesn’t shock us that people responded to something related to colon health via the mail. Some may say “snail mail” has gone away, but not in cases where the “ask” involves a very personal and somewhat embarrassing topic (for some) like colorectal cancer.

Respondents in the study could respond while in the privacy of their own home (and not a busy waiting room or in front of doctors and nurses.) Although as outspoken advocates we’re comfortable talking publicly about colorectal cancer, we need to remember we’re not always the norm. (Maybe we’ll get there one day!) Offering conversations and offers where people can respond in privacy may be the key to getting some individuals screened.

3. Fight the Colonoscopy Stigma

Last – the study reminds us that colonoscopy may still be an uncomfortable topic and avoided procedure for some. Among 60 respondents who returned the FIT test in the study and received abnormal results, 11 still did not undergo colonoscopy.

As we advocate and share our stories, it’s important to break the barriers and provide education about the importance of colonoscopy screening, if abnormal or positive results are found in a FIT test. Videos, pictures and posts about the ease and importance of this procedure can’t hurt – especially personal testimonials!

The more we talk about colonoscopy and CRC screening, the more we can change people’s minds about getting screened.

If only it was as simple as checking the mail.


Read the full study at:

Increasing Colorectal Cancer Screening in a Safety-net Health System With a Focus on the Uninsured: Benefits and Costs