At-Home Mailing of Test Kits Significantly Increases Colorectal Cancer Screening in Adults Under 50

Recent research from UCLA highlights the effectiveness of mailing stool-based at-home test kits to promote colorectal cancer screening among adults aged 45 to 49. The study, published in JAMA, evaluated four different outreach strategies to encourage screening participation in this recently eligible age group, which has historically shown low screening adherence. Findings revealed that automatically mailing a stool-based screening kit (FIT) without requiring active opt-in significantly raised screening rates to over 26%, surpassing other approaches where patients had to select or opt into screening options.

The study involved over 20,000 participants and demonstrated that passive strategies—such as default mailing of test kits—are highly effective in engaging younger, healthier adults who may not yet perceive themselves at risk. Notably, 73% of individuals with abnormal FIT results completed follow-up colonoscopies within six months, underscoring the importance of seamless follow-up procedures.

Colorectal cancer rates are increasing among younger populations, now representing a leading cause of cancer-related deaths in men and women aged 20 to 49. In response, the U.S. Preventive Services Task Force lowered the recommended screening age from 50 to 45 in 2021. However, screening participation remains low, with fewer than 2% of eligible adults being screened within 20 months of the guideline change.

The UCLA study assessed four outreach methods: soliciting opt-in responses for stool tests or colonoscopy, offering a choice between screening options, and simply mailing FIT kits without prior consent. Results showed that automated mailing yielded the highest uptake, with 26.2% of recipients completing screening—more than doubling the rate seen with active opt-in methods.

More importantly, the approach proved to be a cost-effective, scalable intervention capable of saving lives by catching cancers early. The researchers stress the need for continued efforts to optimize mail-based outreach strategies to further improve participation.

This research underscores the urgency of implementing simple, automated screening methods to bridge existing gaps and reduce the rising burden of colorectal cancer among younger adults.

Source: https://medicalxpress.com/news/2025-08-mailing-home-kits-boosts-colorectal.html