Telephone Reminder Call in Addition to Mailing Notification Improved the Acceptance Rate of Colonoscopy in Patients with a Positive Fecal Immunochemical Test

Abstract

Colorectal cancer (CRC) screening with a fecal immunochemical test (FIT) reduces CRC mortality; however, the acceptance rate of a colonoscopy in patients with a positive FIT was not high. The aim of this study was therefore to determine whether a telephone reminder call could increase the acceptance rate of colonoscopy in patients with a positive FIT. We performed FITs for asymptomatic participants aged 50years or older. For patients with a positive FIT, a colonoscopy was recommended via mailing notification only (control group) or via a telephone reminder call after mailing notification (intervention group). The calls informed patients about the significance of a positive FIT and encouraged a colonoscopy following positive FITs. The FIT results were positive in 90 of 8,318 patients who received FITs. Fifty patients were advised to receive colonoscopy via mailing notification only, and 40 patients were advised via both a telephone reminder call and a mailing notification. The acceptance rate of colonoscopy was significantly higher in the intervention group than in the control group (p=0.038). The lesion-detection rate for an advanced neoplasia was also significantly higher in the intervention group than in the control group (p=0.046). According to multivariate logistic regression analysis, a telephone reminder was a significant determinant of colonoscopy acceptance in patients with a positive FIT (OR 4.33; 95% CI, 1.19-15.75; p=0.026). Telephone reminder calls in addition to mailing notification improved the acceptance rate of colonoscopy in patients with a positive FIT.