Colorectal Cancer Screening in a Community Health Setting

This is a single-center RCT at the Family Practice & Counseling Network (FPCN), a community
clinic in Southwest Philadelphia with 320 eligible subjects between the ages of 50-74
randomized to two study arms:

1. text messaging outreach (text)

2. text messaging outreach with lottery for 1/5 chance to win a financial incentive (text +
lottery).

Findings will provide data on the feasibility of this mailed FIT approach in a community
health setting, and how patients respond to text messaging and behavioral economic engagement
incentives.

Inclusion Criteria:

1. Between 50 and 74 years old

2. Has active medical insurance

3. Has had had at least one visit at Health Annex in the prior 12 months (at time of
chart review)

4. Due for CRC screening (no colonoscopy in last 10 years, sigmoidoscopy in last 5 years,
or stool testing in last 1 year)

5. Asymptomatic for CRC

Exclusion Criteria:

1. Has had prior colonoscopy within 10 years, sigmoidoscopy within 5 years, and FOBT/FIT
within twelve months of the chart review (we will exclude patients who self-report
undergoing any of the above procedures)

2. Has a history of CRC

3. Has a history of other GI cancer

4. Has history of confirmed Inflammatory Bowel Disease (IBD) (e.g. Crohns disease,
ulcerative colitis)

5. Has a history of colon polyps

6. Has had a colectomy

7. Has a first-degree relative that has been diagnosed with CRC

8. Has been diagnosed with Lynch Syndrome (i.e. HNPCC)

9. Has been diagnosed with Familial Adenomatous Polyposis (FAP).

10. Has iron deficiency anemia

11. Has recent history of lower GI bleeding

12. Has metastatic (Stage IV) blood or solid tumor cancer

13. Has end stage renal disease

14. Has had congestive heart failure

15. Has dementia

16. Has liver cirrhosis

17. Has any other condition that, in the opinion of the investigator, excludes the patient
from participating in this study

18. Does not use a mobile phone enabled to send and receive text messages