Grant: Operating Grant

Despite widespread distribution of colorectal cancer (CRC) screening guidelines, many Canadians are not screened for CRC. Our research shows that in 2003 only 30% of Canadians received CRC screening according to recommendations. Telehealth, a novel approach to health service delivery, may be an improvement strategy that overcomes common barriers to primary care physician delivery of CRC screening referrals. A 24-month telehealth intervention pilot study is proposed. Participants will be primary care patients who are aged 50-74 years; without previous or current CRC, colon polyps, inflammatory bowel disease or bowel symptoms; and registered in the hospital appointment system database. The primary study objective is to test the feasibility of study methods for a future randomized trial aimed at evaluating the effectiveness of a call-in center on improving CRC screening rates in primary care patients. Feasibility will be assessed using the following indicators: 1) the proportions of invited primary care patients who contact the call-in center, select stool testing and return the completed stool test kit; 2) the average time interval between CRC screening invitation issuing and call-in center contact; 3) the proportion of positive stool tests found; and 4) the proportion of patients with positive stool tests who are referred to gastroenterology or colorectal surgery and/or receive follow-up tests. We will also ascertain the reasons for: non-response to contacting the call-in center, non-adherence to stool test screening, and participation in stool test screening using qualitative data collection and analysis. This study will evaluate a new method of delivering preventive health care to Canadians that may be used in provincial CRC screening programs.