Colorectal Cancer Screening in a Community Health Setting

This is a single-center RCT at the Family Practice & Counseling Network (FPCN), a community clinic in Southwest Philadelphia with 320 eligible subjects between the ages of 50-74 randomized to two study arms:

• text messaging outreach (text)
• text messaging outreach with lottery for 1/5 chance to win a financial incentive (text + lottery).

Findings will provide data on the feasibility of this mailed FIT approach in a community health setting, and how patients respond to text messaging and behavioral economic engagement incentives.

Inclusion criteria

• Between 50 and 74 years old
• Has active medical insurance
• Has had had at least one visit at Health Annex in the prior 12 months (at time of chart review)
• Due for CRC screening (no colonoscopy in last 10 years, sigmoidoscopy in last 5 years, or stool testing in last 1 year)
• Asymptomatic for CRC

Exclusion criteria

• Has had prior colonoscopy within 10 years, sigmoidoscopy within 5 years, and FOBT/FIT within twelve months of the chart review (we will exclude patients who self-report undergoing any of the above procedures)
• Has a history of CRC
• Has a history of other GI cancer
• Has history of confirmed Inflammatory Bowel Disease (IBD) (e.g. Crohns disease, ulcerative colitis)
• Has a history of colon polyps
• Has had a colectomy
• Has a first-degree relative that has been diagnosed with CRC
• Has been diagnosed with Lynch Syndrome (i.e. HNPCC)
• Has been diagnosed with Familial Adenomatous Polyposis (FAP).
• Has iron deficiency anemia
• Has recent history of lower GI bleeding
• Has metastatic (Stage IV) blood or solid tumor cancer
• Has end stage renal disease
• Has had congestive heart failure
• Has dementia
• Has liver cirrhosis
• Has any other condition that, in the opinion of the investigator, excludes the patient from participating in this study
• Does not use a mobile phone enabled to send and receive text messages