by Liver cancer screening rates in patients with cirrhosis nearly doubled when they received a signed order by mail from their specialist, according to a new study conducted by the Perelman School of Medicine at the University of Pennsylvania. The study, published in Hepatology Communications, found that sending patients a signed order for an abdominal ultrasound led to a screening completion rate of approximately 55% within six months. This is in contrast to the 27% completion rate among patients who were offered screening during routine office visits. The intervention, which took place over multiple time periods and involved more than 500 patients, aimed to improve liver cancer surveillance in high-risk groups.
Dr. Shivan Mehta, Associate Professor of Gastroenterology and Associate Chief Innovation Officer at Penn Medicine, highlighted the significance of the study’s findings in increasing liver cancer surveillance among at-risk patients. Early detection of liver cancer is crucial for improving survival rates, particularly in patients with cirrhosis, who are more susceptible to hepatocellular carcinoma, a leading cause of global cancer deaths.
To ensure the ease of decision-making for patients, the researchers utilized behavioral science techniques, such as nudging, by sending mailed orders and letters explaining the importance of liver cancer screenings to patients with cirrhosis. The goal was to ensure that patients made informed decisions and understand the potential risks associated with their condition.
Despite the success of mailed orders, the study also explored the effectiveness of financial incentives in encouraging patients to complete their screenings. In one arm of the study, patients received a $20 incentive along with the mailed order. Surprisingly, there was no significant difference in the completion rates between the incentive group (54.1%) and the non-incentive group (54.5%). This suggests that financial incentives may not be as effective in encouraging preventive health activities, and alternative approaches, such as larger incentives or conditional incentives, may yield better results.
Dr. Mehta emphasized the importance of understanding the preferences and access of patients when it comes to communication methods. While internet and smartphone usage is prevalent, not all patients have equal access. However, the majority of patients can receive mailings, making it a reliable method of communication for delivering important healthcare information.
This study builds on previous research by Dr. Mehta, which demonstrated the effectiveness of mailed colorectal cancer screening kits in increasing screening rates. Financial incentives were not found to be a deciding factor in patients’ decision to complete the screenings. Another recent study by Dr. Mehta also highlighted the effectiveness of mail compared to electronic messaging in reminding patients to get screened for hepatitis C.
Overall, the findings of this study underline the potential benefits of mailing orders and providing informative materials to patients to increase liver cancer screening rates. By employing behavioral science techniques and understanding patient preferences, healthcare providers can enhance preventive care and improve patient outcomes.
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