Colorectal cancer, which affects the colon or rectum, is one of the most common cancers in the United States. Cases are also rising among adults under 50. Despite its prevalence, colorectal cancer is preventable when caught in the early stages with screening.
A new JAMA Network Open study shows that text message reminders improved screening completion rates compared to phone calls.
For Black Americans, who are more likely to be diagnosed with and die from colorectal cancer, early intervention is critical to improving outcomes.
While screening can help detect colorectal cancer early — or potentially even prevent it by finding precancerous polyps (abnormal tissue growths) — many adults are not getting screened regularly.
Research shows that Black adults are more likely to be diagnosed with colorectal cancer at later stages and are more likely to die from the disease compared to other racial groups. Barriers to preventive care, such as limited healthcare access, medical mistrust, transportation barriers, cost concerns, and lack of reminders from healthcare systems, can all contribute to lower screening rates.
These barriers are why researchers are looking for more accessible, affordable ways to encourage people to get screened.
Researchers at NYU Langone Health conducted a randomized clinical trial involving 1,275 adults at eight federally qualified health centers (FQHCs) in Brooklyn, New York. These clinics primarily serve low-income, historically underserved communities.
The participants were split into two groups:
By the end of the study, nearly 59 percent of patients who received text reminders completed their screening test within three weeks. About 50 percent of patients who received a phone call completed the at-home fecal test.
The researchers also found that the text reminders worked similarly across racial and ethnic groups, ages, and insurance types.
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The text messages were designed strategically with behavioral science. Rather than just telling patients to complete the test, the texts used language meant to encourage action.
For example, the messages would:
Researchers believe that these small adjustments helped patients remember to take the test and also feel more encouraged to complete it.
Another significant benefit of text message reminders? They are much easier and cheaper for clinics to send than repeated phone calls.
When nurses called patients, they reached only 46 percent of them. In contrast, they successfully delivered more than 94 percent of text messages.
For many Black people, healthcare barriers can make screenings difficult to prioritize. Caregiving duties, long work hours, limited access to transportation, or lack of consistent primary care can all interfere with routine health appointments.
Automated text messaging could help bridge some of these gaps by making reminders more accessible and convenient. They may also help reduce disparities in preventive care because just about everyone carries a mobile phone — even in communities with fewer healthcare resources.
The study focused on FQHCs, which typically serve patients who are uninsured or underinsured, or who live in medically underserved areas. Many participants were Hispanic, low-income, or Medicaid recipients, making these findings especially relevant for communities experiencing healthcare inequities.
RELATED: Why Colon Cancer Is Rising in Younger Adults—And What You Can Do
The fecal immunochemical test (FIT) is a non-invasive screening test that checks stool samples for hidden blood, which can sometimes be an early sign of colorectal cancer.
Unlike a colonoscopy, the FIT test:
If the FIT test shows abnormal results, you may be required to do a follow-up colonoscopy.
According to the American Cancer Society, people at average risk of colorectal cancer should start regular screening at age 45.
The study underscores how simple communication tools may improve preventive healthcare in underserved communities.
While text message reminders are not a complete solution to eliminating cancer disparities, there may be one practical way to help more people complete screenings earlier — when colorectal cancer is most treatable.
For Black Americans, who continue to face higher colon cancer death rates, increasing access to easy, effective screening reminders could make a meaningful difference.
If you are 45 or older and have not been screened for colorectal cancer, consider talking to your healthcare provider about your options. A quick test today could help protect your future health.
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