Impact of a Proactive Strategy of General Practitioners on CRC Screening (DECORE)

Impact of a Proactive Strategy of General Practitioners on CRC Screening: a Registry-based Cluster-based Randomized Controlled Trial

In this registry-based cluster randomized controlled trial, we will assess the impact of a proactive strategy of general practitioners (GP) who will systematically provide screening kits of colorectal cancer (CRC) to all patients of even age (50, 52, 54...up to 74 years) versus usual practice where the eligible population receive an invitation letter to visit the general practitioner and receive the screening kit.

Study Overview

• Status: Not yet recruiting
• Conditions: Colorectal Cancer
• Intervention / Treatment: Behavioral: Colorectal cancer screening test

Detailed Description

Colorectal cancer is one of the leading causes of cancer and death in France in both men and women. The generalized screening rate is about 30% in France, far from the expected 65%, despite the fact that screening is free and a letter of invitation is sent to the individual's home, and despite the financial incentives provided to the practitioner. Different studies have looked for the causes of non-implementation by the individual: negligence, "dirty"; forgetfulness, and the practitioner: organizational problem, communication problem. A few intervention studies have been carried out with little success: sending the invitation to the individual's home, sending a letter of reminder, sending a letter of general information on screening to the practitioner, sending the list of patients who have not taken the test to the practitioner allows for a few percent improvement in screening. In this registry-based cluster randomized controlled trial, we will assess the impact of a proactive strategy of general practitioners who will systematically provide screening kits of colorectal cancer to all patients of even age (50, 52, 54 years...up to 74 years) versus usual practice where the eligible population receive an invitation letter to visit the general practitioner and receive the screening kit. The screening rate will be calculated for each arm at the end of the 2-year study with data from the health insurance.

• Study Type: Observational
• Enrollment (Estimated): 26260

Contacts and Locations

• Study Contact: Name: Christele BLANC-BISSON, Dr; Phone Number: +33 05 56 65 55 00; Email: christele.blanc-bisson@u-bordeaux.fr
• Study Contact Backup: Name: Pierre POULIZAC; Phone Number: +33 05 57 82 08 49; Email: pierre.poulizac@chu-bordeaux.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Patient between 50 and 74 years old

Description

inclusion criteria:

- medical practices in Aquitaine region and their visiting patients eligible for colorectal cancer screening individuals aged between 50 and 74 years at intermediate risk of colorectal cancer).

Exclusion criteria:

• medical practices with less than five individual eligible for colorectal cancer screening.
• visiting patients aged less than 50 years or more than 74 years or at high or very high risk of colorectal cancer.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Systematic provision of screening tests by GPs; The general practitioner systematically delivers the screening kit with justification and modalities of realization at an even age between 50 and 74 years to the patient who comes to consult for whatever reason, who is at intermediate risk of colorectal cancer and who falls under the generalized screening. The practitioner is helped in his approach by an initial training in the identification of the age, delivery of a poster, a study sheet, stickers and goodies, sending a quarterly letter on the progress of the study and contact with the coordination team.	Behavioral: Colorectal cancer screening test; delivery of colorectal cancer screening test by GP
Delivery of screening test according to GP's usual practice; the GP will issue the CRC screening kit in accordance with his/her usual practice.	Behavioral: Colorectal cancer screening test; delivery of colorectal cancer screening test by GP

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participation rate in CRC screening	The primary endpoint of this trial is the rate of participation rate in CRC screening in the eligible patient population grouped with or without intervention. This criterion will be measured by retrospective analysis of retrospective analysis of National Health Data System data.	2 years after the start of protocol

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Positive test results	Rate of patients with positive test results	2 years after the start of protocol
Positive test at an early stage	rate of patients tested positive at an early stage	2 years after the start of protocol
Positive test at a last stage	rate of patients testing positive at a late stage	2 years after the start of protocol

Collaborators and Investigators

• Sponsor: University Hospital, Bordeaux

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): January 1, 2028
• Study Completion (Estimated): January 1, 2028

Study Registration Dates

• First Submitted: October 28, 2024
• First Submitted That Met QC Criteria: October 28, 2024
• First Posted (Actual): October 29, 2024

Study Record Updates

• Last Update Posted (Estimated): September 11, 2025
• Last Update Submitted That Met QC Criteria: September 10, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: colorectal cancer screening; general practitioner; social health inequalities
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Intestinal Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colonic Diseases; Colorectal Neoplasms
• Other Study ID Numbers: CHUBX 2021/64

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No