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Uptake and Positive Predictive Value of Fecal Occult Blood Tests: A Randomized Controlled Trial
Preventive Medicine
  • Jessica Chubak
  • Andy Bogart
  • Sharon Fuller
  • Sharon S. Laing, University of Washington Tacoma
  • Beverly B. Green
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Objective The aim of this study is to compare the uptake of three mailed high-sensitivity fecal occult blood tests (FOBTs). Methods We conducted a parallel 3-arm randomized controlled trial in an integrated healthcare delivery system in Washington State. From January 2010 through February 2011, automated data were used to identify potentially eligible patients aged 50-74 due for colorectal cancer screening. Participants were mailed one of three FOBT kits (1-sample OC-Auto® fecal immunochemical test [FIT], 2-sample InSure® FIT, or 3-sample guaiac Hemoccult SENSA®), instructions, and a postage-paid return envelope. We performed a modified intent-to-treat analysis with return of any FOBT within 6 months of randomization as the primary outcome. Results Of the 9922 people invited, 2873 returned surveys, 2263 were randomized, and 2234 were analyzed. FOBTs were returned by 1431 participants. At 6 months post-randomization, the proportions screened by any FOBT were 0.69 (95% confidence interval [CI] 0.66-0.72) for the OC-Auto arm, 0.64 (95% CI: 0.61-0.68) for the InSure arm, and 0.61 (95% CI: 0.58-0.65) for the Hemoccult SENSA arm (P < 0.001 for any difference). Pairwise comparisons showed significant differences between the OC-Auto group and each of the other groups after correction for multiple comparisons. Conclusion Uptake of mailed FOBT kits varies by kit type.
open access
Citation Information
Jessica Chubak, Andy Bogart, Sharon Fuller, Sharon S. Laing, et al.. "Uptake and Positive Predictive Value of Fecal Occult Blood Tests: A Randomized Controlled Trial" Preventive Medicine Vol. 57 Iss. 5 (2013) p. 671 - 678
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