A mailed fecal immunochemical test for colorectal cancer screening, unrequested by the recipient, proved the best way to entice adults 45 to 49 years of age to undergo CRC screening, researchers from UCLA determined.
In a randomized trial of 20,509 adults aimed to evaluate the best means of boosting CRC screening among this age group, which became eligible for screening in 2021 under guidelines set by the U.S. Preventive Services Task Force. Of the four strategies tested, the option found to be most acceptable was automatically being mailed a stool-based screening test, with no choice to “opt in” or “opt out.” This option resulted in the highest screening rates (JAMA 2025;334[9]:778-787).
“There has been an urgent need for evidence on how to reach adults in their 40s with effective, scalable screening strategies. We found that removing the need for patients to actively opt into screening can lead to better outcomes, especially when we are trying to engage generally healthy young adults who probably are not perceiving themselves at risk for cancer,” said senior investigator Folasade May, MD, an associate professor of medicine at the David Geffen School of Medicine at UCLA, in Los Angeles.