- A $10 reward or entry into a lottery led to an increase in completion of mailed fecal immunochemical test (FIT) screening kits, but not overall colorectal cancer (CRC) screening.
Why this matters
- Financial incentives could reduce the disparity of CRC screening among disadvantaged populations.
- 838 individuals who were due for CRC screening but had no CRC history were randomly assigned to receive up to 3 standard mailings, 3 mailings with a guarantee of $10 cash upon screening completion, or 3 mailings with a lottery giving them a 1 in 10 chance to win $50.
- Funding: National Cancer Institute.
- Within 6 months, there was no significant difference in CRC screening completion rate among the 3 groups (monetary, 76.7%; lottery, 74.6%; mail only, 71.5%; P=.11).
- For FIT completion, compared with mail only, there were significant increases in completion percentage in the monetary group (+7.7%; 95% CI, 0.3%-15.1%) and the lottery group (+7.1%; 95% CI, −0.2% to 14.3%; P=.04).
- Among Medicaid patients, financial incentives (monetary+lottery combined) led to net increase in FIT completion of 37.7% (95% CI, 11.0%-64.3%) compared with 5.6% (95% CI, −0.9% to 12.2%) for other insurance types.
- Relied on mailed screening questionnaires.