# Effect of reminder phone calls in the language of origin on colorectal cancer screening participation among immigrants in Norway: a randomised controlled trial

## TL;DR

A study in Norway found that reminder phone calls in immigrants' native language increased colorectal cancer screening participation compared to reminders in Norwegian alone.

## Contribution

This study demonstrates that language-specific phone reminders can significantly improve screening participation among immigrant populations.

## Key findings

- Reminder phone calls in the language of origin doubled screening participation among Pakistani and Somali immigrants.
- Participation rates were 24% in the intervention group versus 11% in the control group.
- The effect was consistent across both nationality groups, with risk ratios of 2.50 for Pakistanis and 1.94 for Somalis.

## Abstract

The effect of providing oral information in immigrants’ language of origin on screening participation remains unclear. This study aimed to assess the effect of a reminder phone call in the language of origin combined with a reminder letter in Norwegian, compared to only a reminder letter in Norwegian, on participation in ColorectalScreen Norway among immigrants from Pakistan and Somalia.

We conducted a randomised controlled trial among individuals born in Pakistan or Somalia (age 55–56) who did not return a faecal immunochemical test (FIT) within six weeks after the kit was mailed. Individuals were randomised (1:1), to receive a reminder letter in Norwegian and a phone call in their language of origin (intervention) or solely the reminder letter (control). The primary outcome was participation in ColorectalScreen Norway, defined as return of the kit within 12 weeks after sending the reminder letter. ClinicalTrials.gov: NCT06324409.

We included 416 individuals (215 men and 201 women) during the period from March to October 2024: 217 in the intervention group and 199 in the control group. Overall participation was 24% (53/217) in the intervention group and 11% (22/199) in the control group (risk ratio 2·21 (95% confidence interval (CI) 1·40–3·49)). Participation among Pakistani immigrants was 30% (30/101) in the intervention group and 12% (12/101) in the control group (risk ratio 2·50 (95% CI 1·36–4·60)), and among Somali immigrants 20% (23/116) and 10% (10/98), respectively (risk ratio 1·94 (95% CI 0·97–3·88)) (pheterogeneity = 0·5110).

Reminder phone calls in the individuals’ language of origin doubled the participation rate among immigrants from Pakistan and Somalia in ColorectalScreen Norway, with consistent effects across both nationality groups. The results highlight the complexity and diversity of ensuring access to cancer screening for all and demonstrate the potential of oral information to reach immigrants.

The Norwegian Cancer Society.