***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To conduct a r and omized controlled trial to evaluate the cost effectiveness of a lay health worker-administered cervical cancer screening intervention for Vietnamese-American women . METHODS The study group included 234 Vietnamese women in the Seattle , Washington area who had not received a Pap test in the last three years . Experimental group participants received a lay health worker home visit . The travel distance and time spent at each visit were recorded . Our trial end-point was Pap smear receipt within six months of r and omization . Pap testing completion was ascertained through medical record review s. RESULTS For all Vietnamese women , regardless of their prior history of screening , the cost per intervention was $ 104.0 ( 95 % CI : $ 89.6-$118.4 ) . The change in quality -adjusted life days per intervention was 1.26 ( 95 % CI : -5.43 - 7.96 ) , result ing in an incremental cost-effectiveness ratio ( ICER ) of $ 30,015 per quality -adjusted life year . The probability that the ICER exceeds $ 100,000 is 9.1 % . CONCLUSIONS The degree of cost effectiveness of such interventions is sensitive to the assumed duration of behavioral change and the participants ' prior history of screening Abstract BACKGROUND : R and omized controlled trials have demonstrated that fecal occult blood testing ( FOBT ) reduces colorectal cancer ( CRC ) mortality . However , patient compliance with FOBT is low and this is one of the major barriers to CRC screening . OBJECTIVE : To determine whether intensive patient education increases FOBT card return rates . DESIGN : R and omized controlled trial . SETTING : Department of Veterans Affairs primary care clinic . PARTICIPANTS : Seven hundred eighty-eight patients who were referred for FOBT . INTERVENTIONS : Patients were r and omly allocated to receive either intensive ( n=396 ) or st and ard ( n=392 ) patient education . Patients in the intensive education group received a one-on-one educational session by primary care nurses on the importance of CRC screening , were instructed on how to properly collect stool specimens for FOBT , and were given a 2-page h and out on CRC screening . Patients in the st and ard education group only received the FOBT cards and written instructions from the manufacturer on how to properly collect stool specimens for FOBT . RESULTS : Patients in the intensive education group were more likely to return the FOBT cards ( 65.9 % vs 51.3 % ; P<.001 ) and called the clinic with additional questions less often ( 1.5 % vs 5.9 % ; P=.001 ) than the st and ard education group . The median time to return the FOBT cards was significantly shorter in the intensive education group ( 36 vs 143 days ; P<.001 by log-rank test ) . However , the proportion of patients who had a positive FOBT did not differ in the two groups ( 4.6 % vs 6.0 % ; P=.51 ) . CONCLUSIONS : Intensive patient education significantly improved patient compliance with FOBT . Future studies to evaluate additional educational strategies to further improve patient compliance with CRC screening are warranted Objectives Screening for colorectal cancer is considered cost effective , but is underutilized in the U.S. Information on the efficiency of " tailored interventions " to promote colorectal cancer screening in primary care setting s is limited . The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control ( CDC ) web-based intervention ( screen for life ) and to a tailored interactive computer-based intervention . Methods A r and omized controlled trial of people 50 and over , was conducted to test the interventions . The sample was 1224 partcipants 50 - 70 years of age , recruited from Kelsey-Seybold Clinic , a large multi-specialty clinic in Houston , Texas . Screening status was obtained by medical chart review after a 12-month follow-up period . An " intention to treat " analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects . Analysis of statistical uncertainty was conducted using nonparametric bootstrapping . Results The estimated cost of implementing the web-based intervention was $ 40 per person and the cost of the tailored intervention was $ 45 per person . The additional cost per person screened for the web-based intervention compared to no intervention was $ 2602 and the tailored intervention was no more effective than the web-based strategy . Conclusions The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion . The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion . Research ers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening Background . Colorectal cancer is the second leading cause of cancer-related death in the United States . Despite universal screening recommendations , screening rates in the United States remain suboptimal , especially among the poor , the uninsured , recent immigrants , and Hispanics . This article describes the development of a large community-based colorectal cancer screening program design ed to address these disparities . Method . The Against Colorectal Cancer in our Neighborhoods program is a bilingual , evidence -based , theory-guided , multicomponent community screening intervention , targeting the uninsured and developed using a systematic planning process . It combines community health worker – led outreach , bilingual and culturally tailored community education , and no-cost screening with provision of the fecal immunochemical test or colonoscopy and navigation services . A detailed process and outcome evaluation is planned . Program development cost calculated prospect ively ( in 2011 dollars ) using a societal perspective and micro-costing methods was $ 243,278 , of which $ 180,344 was direct cost . Discussion . The detailed description of the development processes and costs of this health promotion program targeting low-income Hispanics will inform health program decision makers about the re source requirements for planning and developing new programs to reduce disease burden in communities Background Sending faecal occult blood tests ( FOBT ) by mail has been proposed both as a method to increase participation and a way to reduce staff costs in colorectal cancer screening . Methods Two multicentre r and omized controlled trials ( IS RCT N10351276 ) were performed : one r and omly assigned 3196 individuals who had previously participated in colorectal screening to receive a  FOBT kit at home or a st and ard invitation ;  in the second , 4219 people aged 50–69 years who did not respond to a screening invitation were either sent a FOBT or a st and ard recall letter . The cost per returned kit was calculated in each arm . Results Participation was higher with direct FOBT mailing in both trials : relative risk 1.11 ( 95 % CI 1.06–1.17 ) and 1.36 ( 95 % CI 1.16–1.60 ) for previous responders and non-responders , respectively . The cost per returned kit for previous responders ranged from 4.24 € to 16.10 € , and from 3.29 € to 7.36 € with FOBT mailing and st and ard invitation , respectively , not including staff costs ; for non-responders it ranged from 17.13 € to 46.80 € , and from 7.36 € to 18.30 € with FOBT mailing and st and ard recall , respectively . Conclusions The FOBT mailing strategy modestly increased participation . This method can be used on a population of previous responders to reduce personnel costs and workload . When used as a reminder to non-responders , this method increases costs PURPOSE Colorectal cancer screening is underused , particularly in the Veterans Affairs ( VA ) population . In a r and omized controlled trial , a health care provider-directed intervention that offered quarterly feedback to physicians on their patients ' colorectal cancer screening rates led to a 9 % increase in colorectal cancer screening rates among veterans . The objective of this secondary analysis was to assess the cost effectiveness of the colorectal cancer screening promotion intervention . METHODS Providers in the intervention arm attended an educational workshop on colorectal cancer screening and received confidential feedback on individual and group-specific colorectal cancer screening rates . The primary end point was completion of colorectal cancer screening tests . Sensitivity analyses investigated cost-effectiveness estimates varying the data collection methods , costs of labor and technology , and the effectiveness of the intervention . RESULTS Rates of colorectal cancer screening for the intervention versus control arms were 41.3 % v 32.4 % , respectively ( P < .05 ) . The incremental cost-effectiveness ratio was dollar 978 per additional veteran screened based on feedback reports generated from manual review of records . However , if feedback reports could be generated from information technology systems , sensitivity analyses indicate that the cost-effectiveness estimate would decrease to dollar 196 per additional veteran screened . CONCLUSION An intervention based on quarterly feedback reports to physicians improved colorectal cancer screening rates at a VA medical center . This intervention would be cost effective if relevant data could be generated by existing information technology systems . Our findings may have broad applicability because a 2005 Medicare initiative will provide the VA electronic medical record system as a free benefit to all US physicians Purpose : Low-cost interventions to improve cancer screening among primary care patients are needed . The comparative effectiveness of personalized letters , automated telephone calls , and both on breast cancer ( BC ) and colorectal cancer ( CRC ) screening is not known . Methods : A pragmatic , r and omized , controlled trial was conducted in 2011 to 2012 . Eligible primary care patients were women ages 50 to 74 years who were past due for mammography and men or women who were past due for mammography or CRC screening of any kind ( > 12 months since last fecal occult blood test , > 5 years since last sigmoidoscopy/double-contrast barium enema , or > 10 years since last colonoscopy ) , respectively . Participants were r and omized to 1 of 3 interventions : personalized mailed letters , automated telephone calls , or both . The primary outcome was medical record documentation of a completed mammogram or CRC screening within 36 weeks of r and omization . We estimated the costs of each intervention and calculated the marginal cost-effectiveness per person screened . Results : The crude screening rates for BC were 19 % , 22 % , and 37 % and for CRC were 17 % , 14 % , and 24 % for the letter , automated call , and combined ( letter/automated call ) groups , respectively . The combined intervention group had a statistically higher screening rate ( P < .05 ) compared with either of the single intervention groups ( letter only or automated call ) for both BC and CRC in both the crude and adjusted analyses . The combined intervention costs $ 5.11 per additional person screened for BC and $ 13.14 per additional person screened for CRC . Conclusion : In a primary care practice , letters plus automated telephone calls are better than either alone in increasing cancer screening rates among patients who are overdue for screening . These findings suggest the promise of a relatively inexpensive intervention to improve cancer screening Background Colorectal cancer ( CRC ) screening rates are low in many areas and cost-effective interventions to promote CRC screening are needed . Recently in a r and omized controlled trial , a mailed educational reminder increased CRC screening rates by 16.2 % among U.S. Veterans . The aim of our study was to assess the costs and cost-effectiveness of a mailed educational reminder on fecal occult blood test ( FOBT ) adherence . Methods In a blinded , r and omized , controlled trial , 769 patients were r and omly assigned to the usual care group ( FOBT alone , n = 382 ) or the intervention group ( FOBT plus a mailed reminder , n = 387 ) . Ten days after picking up the FOBT cards , a 1-page reminder with information related to CRC screening was mailed to the intervention group . Primary outcome was number of returned FOBT cards after 6 months . The costs and incremental cost-effectiveness ratio ( ICER ) of the intervention were assessed and calculated respectively . Sensitivity analyses were based on varying costs of labor and supplies . Results At 6 months after card distribution , 64.6 % patients in the intervention group returned FOBT cards compared with 48.4 % in the control group ( P < 0.001 ) . The total cost of the intervention was $ 962 or $ 2.49 per patient , and the ICER was $ 15 per additional person screened for CRC . Sensitivity analysis based on a 10 % cost variation was $ 13.50 to $ 16.50 per additional patient screened for CRC . Conclusions A simple mailed educational reminder increases FOBT card return rate at a cost many health care systems can afford . Compared to other patient-directed interventions ( telephone , letters from physicians , mailed reminders ) for CRC screening , our intervention was more effective and cost-effective Purpose The purpose of this study was to evaluate the cost effectiveness of colorectal cancer screening interventions with their effects on health disparity being considered . Material s and Methods Markov cohort simulation was conducted with the cycle/ duration of 1/40 year(s ) . Data came from the results of r and omized trials and others . Participants were hypothetical cohorts aged 50 years as of year 2013 in 16 Korean provinces . The interventions until the age of 80 were annual organized fecal occult blood test ( FOBT ) ( st and ard screening ) , annual FOBT with basic reminders for provinces with higher mortalities than the national average ( targeted reminder ) 
    Output:
    
Multicomponent interventions to increase cervical and colorectal cancer screening were cost effective based on a very conservative threshold .
Additionally , multicomponent interventions for colorectal cancer screening demonstrated net cost savings .