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You Got What In The Mail? Home Test Boosts Colon Cancer Screening

Everybody's supposed to get screened for colon cancer starting at age 50, but many of us haven't gotten around to it. That's especially true in the Latino community, where about half of people are up to date on screening, compared to 66 percent of non-Latino whites.

The numbers get even worse for people who don't have health insurance, with just 37 percent getting screened. So researchers decided to see if something as simple as mailing free home colon-cancer test kits to patients of clinics that serve low-income residents in Portland, Ore., would help get more people screened for colon cancer.

Short story, it did. A bit more than one-third of the 213 people who got the kits in the mail used them and mailed them back.That's 40 percent higher than in earlier studies testing the mail-in concept, which didn't use electronic medical records to follow up with a postcard or phone reminders. And it was a lot higher than the number of eligible clinic patients who were getting tested overall. That number was a mere 1 percent.

Of the 81 patients who were tested, seven had a positive test result, indicating traces of blood in the stool. Those patients were referred for colonoscopies, and all but one patient went in for the procedure. About half of the participants were Hispanic, and most had household incomes below the federal poverty line.

This sounds like a total win; the mail-in tests are cheap, running $12 to $20 per test, compared to more than $1,000 for a colonoscopy. The test, called a fecal immunochemical test or FIT, is 95 percent accurate, and it doesn't require people to change their diet or quit taking medications, as earlier fecal tests did.

But Gloria Coronado, the lead author of the study and a senior investigator at the Kaiser Permanente Center for Health Research, says that because the FIT test should be done every year, costs can add up for clinics that serve large numbers of uninsured people. "Some just bill for the clinic visit," Coronado told Shots. "Unless they change that structure, it might be hard to sustain."

Another issue is making sure that people have access to colonoscopy if they get a positive FIT test, Coronado says. The colonoscopies provided in this study were donated by the doctors.

But for now, they're moving forward. Coronado and her team have gotten money from the National Institutes of Health to expand the project to 26 federally funded health centers in Oregon and California, starting in February.

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