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In this registry-based cluster randomized controlled trial, we will assess the impact of a proactive strategy of general practitioners (GP) who will systematically provide screening kits of colorectal cancer (CRC) to all patients of even age (50, 52, 54...up to 74 years) versus usual practice where the eligible population receive an invitation letter to visit the general practitioner and receive the screening kit.
Colorectal cancer is one of the leading causes of cancer and death in France in both men and women. The generalized screening rate is about 30% in France, far from the expected 65%, despite the fact that screening is free and a letter of invitation is sent to the individual's home, and despite the financial incentives provided to the practitioner. Different studies have looked for the causes of non-implementation by the individual: negligence, "dirty"; forgetfulness, and the practitioner: organizational problem, communication problem. A few intervention studies have been carried out with little success: sending the invitation to the individual's home, sending a letter of reminder, sending a letter of general information on screening to the practitioner, sending the list of patients who have not taken the test to the practitioner allows for a few percent improvement in screening. In this registry-based cluster randomized controlled trial, we will assess the impact of a proactive strategy of general practitioners who will systematically provide screening kits of colorectal cancer to all patients of even age (50, 52, 54 years...up to 74 years) versus usual practice where the eligible population receive an invitation letter to visit the general practitioner and receive the screening kit. The screening rate will be calculated for each arm at the end of the 2-year study with data from the health insurance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Systematic provision of screening tests by GPs | The general practitioner systematically delivers the screening kit with justification and modalities of realization at an even age between 50 and 74 years to the patient who comes to consult for whatever reason, who is at intermediate risk of colorectal cancer and who falls under the generalized screening. The practitioner is helped in his approach by an initial training in the identification of the age, delivery of a poster, a study sheet, stickers and goodies, sending a quarterly letter on the progress of the study and contact with the coordination team. |
| |
| Delivery of screening test according to GP's usual practice | the GP will issue the CRC screening kit in accordance with his/her usual practice. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Colorectal cancer screening test | Behavioral | delivery of colorectal cancer screening test by GP |
|
| Measure | Description | Time Frame |
|---|---|---|
| Participation rate in CRC screening | The primary endpoint of this trial is the rate of participation rate in CRC screening in the eligible patient population grouped with or without intervention. This criterion will be measured by retrospective analysis of retrospective analysis of National Health Data System data. | 2 years after the start of protocol |
| Measure | Description | Time Frame |
|---|---|---|
| Positive test results | Rate of patients with positive test results | 2 years after the start of protocol |
| Positive test at an early stage | rate of patients tested positive at an early stage |
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inclusion criteria:
- medical practices in Aquitaine region and their visiting patients eligible for colorectal cancer screening individuals aged between 50 and 74 years at intermediate risk of colorectal cancer).
Exclusion criteria:
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Patient between 50 and 74 years old
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christele BLANC-BISSON, Dr | Contact | 05 56 65 55 00 | +33 | christele.blanc-bisson@u-bordeaux.fr |
| Pierre POULIZAC | Contact | 05 57 82 08 49 | +33 | pierre.poulizac@chu-bordeaux.fr |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| 2 years after the start of protocol |
| Positive test at a last stage | rate of patients testing positive at a late stage | 2 years after the start of protocol |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |