Trial Outcomes & Findings for Scaling CRC Screening Through Outreach, Referral, and Engagement (SCORE) (NCT NCT04406714)

NCT ID: NCT04406714

Last Updated: 2026-05-15

Results Overview

"The proportion of subjects who received study Intervention (Age Group 50-75) and did not receive study intervention (Usual Care - Age Group 50-75 who completed CRC screening using any of the screening modalities recommended by the United States Preventive Services Task Force per electronic health record review. Fecal immunochemical test (FIT), fecal occult blood test \[FOBT\], fecal immunochemical test - deoxyribonucleic acid (FIT-DNA), colonoscopy, flexible sigmoidoscopy, flexible sigmoidoscopy with FIT, Computerized Tomography colonography."

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

4318 participants

Primary outcome timeframe

Up to 6 months after randomization

Results posted on

2026-05-15

Participant Flow

Subjects were enrolled between 07/07/2020 - 02/28/2022 in one center in North Carolina.

Participant milestones

Participant milestones
Measure
Experimental: Trial Mailed FIT - Age Group 50-75
Subjects randomized to this arm are 50-75 years of age and eligible for CRC screening using FIT per electronic health record at either of the two study sites. This arm receives a mailed FIT and up to two reminder letters.
No Intervention: Trial Usual Care - Age Group 50-75
Subjects randomized to this arm are 50-75 years of age and eligible for CRC screening using FIT per electronic health record at either of the two study sites. This arm receives the usual care.
Experimental: Sub-study Mailed FIT Age Group 45-49 Enhanced Envelope
Subjects randomized to this arm are 45-49 years of age and eligible for CRC screening using FIT per electronic health record at one study site. This arm receives a mailed FIT in an enhanced mailing envelope and up to two reminder letters.
Active Comparator: Sub-study Mailed FIT Comparator Plain Envelope - Age Group 45-49
Subjects randomized to this arm are 45-49 years of age and eligible for CRC screening using FIT per electronic health record at one study site. This arm receives a mailed FIT in a plain envelope and up to two reminder letters.
Overall Study
STARTED
2001
2001
158
158
Overall Study
COMPLETED
2001
2001
158
158
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Scaling CRC Screening Through Outreach, Referral, and Engagement (SCORE)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Experimental: Trial Mailed FIT - Age Group 50-75
n=2001 Participants
Subjects randomized to this arm are 50-75 years of age and eligible for CRC screening using FIT per electronic health record at either of the two study sites. This arm receives a mailed FIT and up to two reminder letters.
No Intervention: Trial Usual Care - Age Group 50-75
n=2001 Participants
Subjects randomized to this arm are 50-75 years of age and eligible for CRC screening using FIT per electronic health record at either of the two study sites. This arm receives the usual care.
Experimental: Sub-study Mailed FIT Age Group 45-49 Enhanced Envelope
n=158 Participants
Subjects randomized to this arm are 45-49 years of age and eligible for CRC screening using FIT per electronic health record at one study site. This arm receives a mailed FIT in an enhanced mailing envelope and up to two reminder letters.
Active Comparator: Sub-study Mailed FIT Comparator Plain Envelope - Age Group 45-49
n=158 Participants
Subjects randomized to this arm are 45-49 years of age and eligible for CRC screening using FIT per electronic health record at one study site. This arm receives a mailed FIT in a plain envelope and up to two reminder letters.
Total
n=4318 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=11 Participants
0 Participants
n=9 Participants
0 Participants
n=20 Participants
0 Participants
n=186 Participants
0 Participants
n=12 Participants
Age, Categorical
Between 18 and 65 years
1487 Participants
n=11 Participants
1496 Participants
n=9 Participants
158 Participants
n=20 Participants
158 Participants
n=186 Participants
3299 Participants
n=12 Participants
Age, Categorical
>=65 years
514 Participants
n=11 Participants
505 Participants
n=9 Participants
0 Participants
n=20 Participants
0 Participants
n=186 Participants
1019 Participants
n=12 Participants
Sex: Female, Male
Female
1135 Participants
n=11 Participants
1121 Participants
n=9 Participants
84 Participants
n=20 Participants
97 Participants
n=186 Participants
2437 Participants
n=12 Participants
Sex: Female, Male
Male
866 Participants
n=11 Participants
880 Participants
n=9 Participants
74 Participants
n=20 Participants
61 Participants
n=186 Participants
1881 Participants
n=12 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
185 Participants
n=11 Participants
179 Participants
n=9 Participants
13 Participants
n=20 Participants
12 Participants
n=186 Participants
389 Participants
n=12 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1687 Participants
n=11 Participants
1679 Participants
n=9 Participants
141 Participants
n=20 Participants
145 Participants
n=186 Participants
3652 Participants
n=12 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
129 Participants
n=11 Participants
143 Participants
n=9 Participants
4 Participants
n=20 Participants
1 Participants
n=186 Participants
277 Participants
n=12 Participants
Race (NIH/OMB)
American Indian or Alaska Native
4 Participants
n=11 Participants
8 Participants
n=9 Participants
1 Participants
n=20 Participants
2 Participants
n=186 Participants
15 Participants
n=12 Participants
Race (NIH/OMB)
Asian
17 Participants
n=11 Participants
10 Participants
n=9 Participants
0 Participants
n=20 Participants
3 Participants
n=186 Participants
30 Participants
n=12 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
3 Participants
n=11 Participants
1 Participants
n=9 Participants
1 Participants
n=20 Participants
0 Participants
n=186 Participants
5 Participants
n=12 Participants
Race (NIH/OMB)
Black or African American
549 Participants
n=11 Participants
536 Participants
n=9 Participants
88 Participants
n=20 Participants
96 Participants
n=186 Participants
1269 Participants
n=12 Participants
Race (NIH/OMB)
White
1272 Participants
n=11 Participants
1295 Participants
n=9 Participants
50 Participants
n=20 Participants
44 Participants
n=186 Participants
2661 Participants
n=12 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=11 Participants
0 Participants
n=9 Participants
0 Participants
n=20 Participants
0 Participants
n=186 Participants
0 Participants
n=12 Participants
Race (NIH/OMB)
Unknown or Not Reported
156 Participants
n=11 Participants
151 Participants
n=9 Participants
18 Participants
n=20 Participants
13 Participants
n=186 Participants
338 Participants
n=12 Participants
Region of Enrollment
United States
2001 Participants
n=11 Participants
2001 Participants
n=9 Participants
158 Participants
n=20 Participants
158 Participants
n=186 Participants
4318 Participants
n=12 Participants

PRIMARY outcome

Timeframe: Up to 6 months after randomization

Population: Subjects who actively receive health care from the study sites, aged between 50-75.

"The proportion of subjects who received study Intervention (Age Group 50-75) and did not receive study intervention (Usual Care - Age Group 50-75 who completed CRC screening using any of the screening modalities recommended by the United States Preventive Services Task Force per electronic health record review. Fecal immunochemical test (FIT), fecal occult blood test \[FOBT\], fecal immunochemical test - deoxyribonucleic acid (FIT-DNA), colonoscopy, flexible sigmoidoscopy, flexible sigmoidoscopy with FIT, Computerized Tomography colonography."

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=2001 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=2001 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Proportion of Subjects Who Completed Colorectal Cancer (CRC) Screening Within 6 Months (Trial - Age Group 50-75)
192 Participants
598 Participants

SECONDARY outcome

Timeframe: Up to 60 days after randomization

Population: Subjects who actively receive health care from the study sites, aged between 50-75.

The proportion of subjects who received study Intervention (Age Group - 50-75) and returned a completed FIT per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=2001 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Proportion of Subjects Who Returned a Completed Mailed FIT at 60 Days
409 Participants

SECONDARY outcome

Timeframe: Up to 6 months after diagnostic colonoscopy referral date

Population: Subjects who started the study and were assessed for colon carcinoma within 6 months.

The proportion of subjects who received study Intervention (Age Group 50-75) and did not receive study information (Usual Care only - Age Group 50-75), who had a positive (abnormal) FIT/FOBT result, and for whom colonoscopy was deemed to be clinically appropriate by the subject's provider, who completed follow-up (diagnostic) colonoscopy per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=26 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=81 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Proportion of Subjects Who Completed a Follow-up (Diagnostic) Colonoscopy
Abnormal FIT
18 Participants
48 Participants
Proportion of Subjects Who Completed a Follow-up (Diagnostic) Colonoscopy
Completed colonoscopy
8 Participants
33 Participants

SECONDARY outcome

Timeframe: Up to 12 months after screening or diagnostic colonoscopy result date

Population: Subjects who participated to the study and were diagnosed with colorectal carcinoma.

Number of CRCs and advanced adenomas detected among subjects who received study Intervention (Age Group 50-75) and subjects who did not receive study intervention (Usual Care only - Age Group 50-75) per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=192 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=598 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Number of Subject Colorectal Carcinoma (CRC) and Advanced Adenomas Detected at 12 Months
8 Participants
22 Participants

SECONDARY outcome

Timeframe: Up to 12 months after CRC diagnosis

Population: Participants were diagnosed with CRC ever during Round 1. Five subjects from Trial Mailed FIT Intervention - Age Group 50-75 and 2 subjects from Trial Usual Care - Age Group 50-75 were evaluated for treatment.

Number of days from CRC diagnosis to the date of evaluation for CRC treatment among subjects who received study Intervention (Age Group 50-75) and subjects who did not receive study intervention (Usual Care - Age Group 50-75) using electronic health record data to ascertain the dates of CRC diagnosis and evaluation for CRC treatment.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=2 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=5 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Number of Days From CRC Diagnosis to the Date of Evaluation for CRC Treatment
0 days
Interval 0.0 to 0.0
3.25 days
Interval 0.0 to 13.0

SECONDARY outcome

Timeframe: Up to 6 months after cancer diagnosis date

Population: Subjects who received a referral for cancer treatment.

Number of subjects who received study Intervention (Age Group 50-75) and did not receive intervention (Age Group 50-75) who received referral for cancer treatment among individuals diagnosed with CRC per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=2 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=5 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Number of Subjects Who Received Referral for Cancer Treatment
2 Participants
4 Participants

SECONDARY outcome

Timeframe: Round 1 time frame: at 6 months after randomization; Round 2 time frame: at 6 months after determining eligibility for Round 2

Population: Subjects who are 50-75 years old received study intervention.

"Number of annual FIT screenings completed (0, 1, or 2) by subjects who received Intervention (Age Group 50-75) after two annual rounds of mailed FIT outreach per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=2001 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
n=1624 Participants
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
n=1624 Participants
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=2001 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Number of Subjects Mailed FITs Completed After Two Rounds of Annual FIT Outreach
261 Participants
116 Participants
252 Participants
1372 Participants

SECONDARY outcome

Timeframe: Through study completion, up to 36 months after randomization

Comparison of the programmatic costs incurred and number of subjects screened in Arm 1(Trial Mailed FIT Intervention - Age Group 50-75) compared to Arm 2 (Trial Usual Care - Age Group 50-75), measured as cost of intervention minus the cost of usual care, divided by the number screened in Arm 1 minus the number screened in Arm 2. Intervention costs will be assessed using periodic episodes of direct observation of mailed FIT outreach activities, time logs maintained by the intervention team, and assembly of administrative data capturing non-personnel/non-labor expenditures, such as costs associated with materials printing, FIT processing, and mailing costs. Usual care costs will be assessed using a combination of clinic observations and interviews with staff.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 6 months after randomization

Population: Screening-eligible population, aged 45-49 years old.

The proportion of subjects in Arm 3 (Sub-study Mailed FIT Intervention Enhanced Envelope - Age Group 45-49) and Arm 4 (Sub-study Mailed FIT Active Comparator Envelope - Age Group 45-49) who are current with any CRC screening compared to baseline, using any of the screening modalities recommended by the United States Preventive Services Task Force (FIT, fecal occult blood test \[FOBT\], FIT-DNA, colonoscopy, flexible sigmoidoscopy, flexible sigmoidoscopy with FIT, CT colonography) per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=158 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=158 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
The Proportion of Subjects, Ages 45-49, Who Are Current With CRC Screening
Screening-eligible population, aged 45-49 years old
158 Participants
158 Participants
The Proportion of Subjects, Ages 45-49, Who Are Current With CRC Screening
Count of screened participants
45 Participants
53 Participants

SECONDARY outcome

Timeframe: 60 days after randomization

Population: Subjects who are between 45-49 old completed mailed FIT at 60 days

The proportion of subjects in Arm 3 (Intervention Enhanced Envelope - Age Group 45-49) compared to subjects in Arm 4 (Intervention Active Comparator Envelope - Age Group 45-49) who returned a completed FIT.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=158 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=158 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Proportion of Subjects, Ages 45-49, Who Completed Mailed FIT at 60 Days
20 Participants
34 Participants

SECONDARY outcome

Timeframe: Up to 6 months after abnormal FIT result date

Population: Subjects who are 45-49 years old completed study intervention.

The proportion of subjects in Arm 3 (Sub-study Mailed FIT Intervention Enhanced Envelope - Age Group 45-49) and Arm 4 (Sub-study Mailed FIT Active Comparator Plain Envelope - Age Group 45-40) with a positive (abnormal) FIT/FOBT result for whom colonoscopy is deemed to be clinically appropriate by the subject's provider who completes a follow-up (diagnostic) colonoscopy per electronic health record review.

Outcome measures

Outcome measures
Measure
Completed 1 Annual FIT Screening Only in Year 1
n=158 Participants
Completed 1 Annual FIT Screening Only in Year 1
Completed 1 Annual FIT Screening Only in Year 2
Completed 1 Annual FIT Screening Only in Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Completed 2 Annual FIT Screenings in Year 1 and Year 2
Trial Mailed FIT Intervention - Age Group 50-75
n=158 Participants
Subjects who are between 50-75 years of age and received study intervention. Trial Mailed FIT Intervention: Subjects are mailed an introductory letter advising them that they will receive a FIT kit in the mail. Next, subjects are mailed a FIT packet in an envelope that contains a cover letter, CRC information sheet, FIT instruction sheet, and FIT kit with a pre-paid return envelope. Subjects receive up to two mailed letters reminding them to complete and return the FIT. Subjects receive FIT results via letter or phone call.
Proportion of Subjects Who Completed a Follow up (Diagnostic) Colonoscopy
positive (abnormal) FIT/FOBT result
1 Participants
2 Participants
Proportion of Subjects Who Completed a Follow up (Diagnostic) Colonoscopy
completed a follow-up colonoscopy
1 Participants
2 Participants

Adverse Events

Experimental: Trial Mailed FIT - Age Group 50-75

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

No Intervention: Trial Usual Care - Age Group 50-75

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Experimental: Sub-study Mailed FIT Age Group 45-49 Enhanced Envelope

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Active Comparator: Sub-study Mailed FIT Comparator Plain Envelope - Age Group 45-49

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Alexis Moore

University of North Carolina Lineberger Comprehensive Cancer Center

Phone: +1 919-962-5409

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place