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Cancer

Low-Literacy Instructions Improve Colorectal Cancer Screening Adherence

Strategic Insights

— 1 min read

A recent study published in the American Journal of Gastroenterology has shed light on the effectiveness of low-literacy instructions in enhancing colorectal cancer screening adherence. The study, conducted by researchers at the Hutchinson Institute for Cancer Outcomes Research, involved 13,971 English-speaking patients and 508 Spanish-speaking patients who were eligible for mailed outreach through an organized colorectal cancer screening program. The researchers compared the completion of fecal immunochemical tests (FIT) among patients who received quick response (QR) code-linked video instructions versus those who received pictorial instructions in their preferred language.

Key Takeaways:

  • The study found that patients who received QR code instructions had a higher completion rate of FIT (33.5% vs 30.4%) compared to those who received pictorial instructions, with an absolute difference of 3.1% (95% CI 1.5-4.6%).
  • The median time to FIT completion was 2 days longer (24 days, 95% CI 23-25) for patients who received QR code instructions versus pictorial instructions.
  • There was no difference in time to FIT completion by language group.
  • The study suggests that providing QR code-based education may be a practical strategy to improve FIT completion for colorectal cancer screening.
  • The findings were similar among English-speaking and Spanish-speaking patients, indicating that the results are applicable to diverse language groups.

Statistics:

  • 13,471 English-speaking patients and 508 Spanish-speaking patients were included in the study.
  • 31.9% of patients who received mailed outreach completed colorectal cancer screening by FIT.
  • The absolute difference in FIT completion rates between QR code instructions and pictorial instructions was 3.1% (95% CI 1.5-4.6%).
  • The median time to FIT completion was 24 days (95% CI 23-25) for patients who received QR code instructions.
  • The study was conducted in an organized colorectal cancer screening program.

Sources:

  • Fecal Immunochemical Test Completion by Instruction Type: A Randomized Clinical Trial Comparing Quick Response Code-Linked Video to Pictorial Instructions. American Journal of Gastroenterology, 2025.
  • Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States.
  • Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.

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