Effect of financial incentives on patient use of mailed colorectal cancer screening tests

This randomised controlled trial investigated whether different forms of financial incentives (unconditional, conditional or lottery) can increase participation in preventative health.  Patients between the ages of 50-75 were recruited who were eligible for colorectal cancer (CRC) screening but were not up-to-date. They were randomized in a 1:1:1:1 ratio to receive (1) no financial incentive; (2) an unconditional $10 incentive included with the mailing; (3) a $10 incentive conditional on FIT completion; or (4) a conditional lottery with a 1-in-10 chance of winning $100 after FIT completion. The completion rate at 6 months was 32.7% in the no incentive arm, 31.7% in the unconditional incentive arm, 26.8% in the conditional incentive arm, and 24.3% in the lottery incentive arm. This study shows that different forms of financial incentives did no incrementally increase FIT completion rates, and were not more effective than FIT outreach alone. Further efforts are needed to increase uptake of CRC screening.

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