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Mobile messenger–initiated reminders improve longitudinal adherence in a community‐based, opportunistic colorectal cancer screening program: A single‐blind, crossover randomized controlled study
Author(s) -
Lam Thomas Y. T.,
Wu Peter I.,
Tang Raymond S. Y.,
Luk Arthur K. C.,
Ng Simpson,
Sung Joseph J. Y.
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33336
Subject(s) - medicine , crossover study , randomization , colorectal cancer , randomized controlled trial , colonoscopy , colorectal cancer screening , cancer , placebo , alternative medicine , pathology
Background The fecal immunochemical test (FIT) is a cost‐effective colorectal cancer (CRC) screening tool. However, longitudinal adherence, a factor that is critical to the success to any FIT‐based screening program, often is poor. The authors hypothesized that reminders sent via mobile messengers, such as WhatsApp, improve such adherence. Methods In the current single‐blind, randomized study, subjects from an opportunistic FIT screening program who had a negative FIT result the year prior were randomly allocated (1:1) to receive either a 1‐off reminder via the WhatsApp messenger (WR) 1 month prior to the due appointments or no reminder (NR). All subjects were blinded to study participation and group allocation. At 24 months after randomization, a crossover of intervention was performed among those individuals who remained in the FIT program. The primary outcome was FIT adherence, defined as the pick‐up and on‐time return of the FIT. The secondary outcome was FIT adherence after the crossover. Results A total of 500 subjects were randomized to receive WR (250 subjects) or NR (250 subjects). Three individuals were excluded from analysis (1 died and 2 underwent colonoscopy). Both the FIT pick‐up rate (80.3% vs 59.3%; P < .001) and return rate (79.9% vs 57.3%; P < .001) were significantly higher in the WR group compared with the NR group. After crossover of intervention (452 subjects), the WR group again was found to have a higher FIT pick‐up rate (79.1% vs 52.9%; P < .001) and return rate (78.2% vs 52.4%; P < .001). Conclusions Text reminders sent via mobile messenger appear to improve the longitudinal adherence to FIT‐based opportunistic CRC screening programs. The routine use of this technology in CRC screening should be considered.