JMIR Publications

ABSTRACT

Background:

Mobile phone text message reminders to increase colorectal cancer (CRC) screening participation have shown moderate effects.

Objective:

This study assessed effectiveness and acceptability of targeted text message reminders for those who picked up but did not return their screening kit at pharmacy within 14 days in a CRC screening program in Catalonia, Spain

Methods:

We performed a randomised control trial in the screening hub of the metropolitan area of Barcelona that covers 502,348 adults aged 50-69 years. In total, 9,369 individuals were randomised in a 1:1 ratio to receive either a text message reminder or no reminder. Main primary outcome was FIT completion rate within 126 days from FIT kit pick-up (intention-to-treat-analysis). A telephone survey assessed acceptability and appropriateness of the intervention. Cost-effectiveness of adding a text message reminder to FIT completion was also performed.

Results:

FIT completion rate was 77.7% in control arm and 82.6% in text message arm. Higher participation rates in intervention arm were reported independent of sex, age, socioeconomic level, and screening profiles. 89.2% of interviewees considered it important and useful to receive text message reminders to FIT completion, and 93.4% preferred text messages to postal letters.

Conclusions:

Adding text message reminders to the standard procedure significantly increased FIT kit return rates and was considered acceptable and appropriate. The SMS plus letter reminder to complete and return the FIT kit was a cost-effective strategy. Clinical Trial: Registration Number NCT04343950 (04/09/2020) at clinicaltrials.gov