Lay Tel Compliance Study
Condition: CRC Screening; Compliance, Patient
Study type: Interventional

Summary: 
      This is a randomized controlled study to compare the effectiveness of interactive telephone
      reminders by a layperson on enhancing compliance with CRC screening by FOBT, when compared
      with usual care (i.e. no intervention).
    

Detailed description: 
      Colorectal cancer (CRC) is one of the major global health challenges. CRC is currently the
      third most common cancer in men and the second common in women worldwide, accounting for
      approximately 10% of all cancers. It leads to 8% of all cancer mortality in the world and it
      is the fourth most common cause of cancer deaths. There were 4,563 new cases and 3,893 new
      deaths in Hong Kong in 2012, while 47.4% of the new cases were diagnosed at stage III or
      above. In the past decades the Asia Pacific countries like China, South Korea, Japan, and
      Singapore have witnessed a two to three-fold rise in incidence, gradually catching up the
      figures in Western countries. The direct medical cost for the care of colorectal neoplasia
      was estimated US$45,115 for stage IV CRC in the initial year of care, bringing a substantial,
      global public health burden to the healthcare systems.

      Randomized controlled studies have shown that CRC screening using Faecal Occult Blood Testing
      (FOBT) is effective in reducing cancer mortality by 15-33%. FOBT as a quick office-based
      procedure has the advantages of being non-invasive, inexpensive, acceptable, feasible,
      patient-friendly and devoid of needs for bowel preparation. A 25% relative risk reduction in
      CRC mortality was found for those attending at least one round of FOBT screening, according
      to a systematic review conducted in 2007. Guidelines from the US Preventive Services Task
      Force, the European Nations, the Asia Pacific Consensus statements and other authorities
      recommended FOBT as one of the first-line screening modalities, especially in
      resource-limited regions. Since yearly testing is recommended to maintain programmatic
      effectiveness, longitudinal adherence is a critical component of FOBT-based screening
      programs. Our previous study conducted in Hong Kong showed that the rate of compliance with
      CRC screening was declining since the first year of enrolment.

      Nevertheless, it remains unknown whether interventions based on reminder systems could
      effectively enhance longitudinal compliance with FOBT, especially among those who have
      already enrolled in a CRC screening programme. Current evidence does not adequately compare
      whether interactive reminder are superior to usual care (i.e. no reminders).
    

Intervention name(s): Telephone reminder; No other
Intervention type(s): Other; Other
Intervention description(s): Interactive telephone reminder by a trained layperson with a standard script to remind return to the center for taking fecal tubes for CRC screening; No additional reminder will be offered
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Screening