An SMS-Based Intervention Approach for Enhancing Colorectal Cancer Screening Rates

Background

Colorectal cancer screening participation is suboptimal and below established targets among the elderly. This study aims to evaluate the impact of an SMS-based reminder system on CRC screening participation and knowledge levels among individuals aged 50-70.

Methods

This non-randomized controlled trial was conducted between December 2025 and April 2026 in Kırklareli, Türkiye, involving 298 individuals aged 50–70. Participants were allocated into two distinct cohorts: the SMS intervention group (n = 149) and the control group (CG, n = 149). The intervention group received daily educational SMS prompts regarding the significance of cancer prevention and screening protocols over a 10-day period, while the CG received standard care. Data was collected both before and 3 months after the intervention, using a questionnaire that included two parts (sociodemographic characteristics and stages of change for cancer screening practices) Statistical analyses were performed using Chi-square tests to evaluate group differences and binary logistic regression to identify independent predictors of screening behavior.

Results

Post-intervention, the SMS group’s screening rate significantly rose to 56.4% (n = 84) compared to 32.2% (n = 48) in the control group (p < 0.001), representing a 24.2% absolute increase. Logistic regression identified the SMS intervention as a strong predictor, increasing participation odds by 2.72 times. Additionally, a significant shift in the ‘Stages of Change’ was observed only in the SMS group, marking a transition from awareness to active screening (p < 0.05).

Conclusions

The results demonstrate that a structured SMS-based intervention serves as a highly effective, low-cost, and scalable strategy for enhancing colorectal cancer screening adherence among older adults.

Key messages

• SMS-based reminders are a cost-effective and powerful tool for public health nurses to significantly boost colorectal cancer screening uptake among individuals aged 50–70.

• The implementation of SMS-mediated reminders effectively addresses disparities in screening access, ensuring higher participation rates across the geriatric demographic