A simple shift from phone calls to text messages could significantly improve colorectal cancer screening rates, according to a new randomized clinical trial.
Researchers found that automated, behaviorally informed text messaging increased completion of fecal immunochemical tests (FIT) compared with traditional nurse-led telephone outreach, highlighting a low-cost and scalable solution for preventive care.
Text Messaging Outperforms Phone Calls
The study, conducted across eight health centers in New York, included 1,275 adults with newly ordered FIT screening. Participants were randomized to receive either a series of three automated text reminders or a single nurse-led phone call.
Within 21 days, 58.9% of patients in the text message group completed their screening, compared with 49.8% in the telephone group. This 9% absolute increase represents a meaningful improvement in uptake.
Early Engagement Drives Results
Differences between the two groups emerged quickly, with higher completion rates in the text message group observed as early as 7 and 14 days.
The intervention used principles from behavioral economics, delivering short, timely reminders designed to prompt action without requiring additional staff involvement.
Consistent Impact Across Populations
Importantly, the effectiveness of text messaging did not vary by age, sex, ethnicity, or patient engagement with digital health tools, suggesting broad applicability across diverse populations.
This is particularly relevant for safety-net settings, where screening rates are often lower and healthcare resources more limited.
A Scalable Solution for Preventive Care
Colorectal cancer screening remains underutilised despite the availability of simple, non-invasive tests like FIT. Traditional outreach methods, such as phone calls, can be resource-intensive and difficult to scale.
The findings suggest that automated messaging not only reduces staff burden but may actually be more effective at prompting patients to act.
Rethinking Patient Outreach
For healthcare systems, the message is clear: convenience and timing matter.
Replacing or supplementing phone-based outreach with targeted text messaging could help close screening gaps, particularly in underserved populations where improving uptake has been challenging.
Looking Ahead
While the study focused on short-term outcomes, it provides strong evidence that small, behaviourally informed interventions can drive meaningful changes in patient behaviour.
In practice, this approach could be extended beyond colorectal cancer screening to support a wide range of preventive health measures, without adding strain to already stretched healthcare systems.
References
Korostoff-Larsson O et al. Behaviorally Informed Text Messaging to Promote Colon Cancer Screening: A Quality Improvement Randomized Clinical Trial. JAMA Netw Open. 2026;9(4):e267122.
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