Keywords: Colorectal cancer screening, Population screening, Cluster randomized controlled trial

Background:

Colorectal cancer (CRC) is a leading cause of cancer mortality worldwide. Organized screening using faecal immunochemical tests (FIT) remains underused in many countries. Prior interventions (telephone calls, GP-signed letters) improve uptake but are often resource-intensive. Scalable, low-burden strategies embedded in primary care are needed.

Research questions:

In primary care, does a physician-based mail reminder increase the proportion of patients up-to-date with colorectal cancer screening compared with usual care?

Method:

CORMAT is a cluster randomized controlled trial conducted in three French regions (Brest, Rennes, and Tours), in which general practitioners are randomized to either usual care or the intervention. The intervention consists of sending a mail reminder to patients aged 50 to 74 years who are not up to date with colorectal cancer screening. The primary outcome is the change in the proportion of screening-up-to-date patients per general practitioner at six months. A total of 80 general practitioners, representing approximately 16,000 patients, will be included.

Results:

By relying on a low-cost and minimally time-consuming strategy embedded in routine practice, CORMAT seeks to provide evidence for a pragmatic intervention that could be easily scaled up and potentially extended to other organized cancer screening programmes.

Conclusions:

By testing a pragmatic intervention embedded in routine general practice, the CORMAT trial aims to provide actionable evidence to improve colorectal cancer screening uptake and inform future national prevention policies

Points for discussion:

to what extent might a simple SMS reminder be more effective than phone or email-based approaches, particularly in populations with varying levels of digital literacy?

he CORMAT trial raises broader methodological considerations regarding the relevance of cluster randomized designs in primary care researc

this study contributes to the ongoing reflection on how healthcare systems should adapt to the growing digitalization of prevention strategies