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Bowel scope screening: interventions to increase uptake in Yorkshire

ABSTRACT: Background and study aims Bowel cancer is the second most common cause of cancer-related deaths in England. Bowel scope screening (BSS) can prevent bowel cancer by removing pre-cancerous growths within the bowel before they become cancerous. Previous research has shown that BSS can lower a person’s risk of getting bowel cancer by a third and their risk of dying from bowel cancer by half. The NHS in England now offers BSS to 55 year olds registered with a general practice (GP), but uptake is low, particularly in more deprived areas. The aim of this study is to find out whether GP practice based interventions can increase uptake of BSS in Hull and other parts of Yorkshire. Who can participate? People aged 55 due to receive their NHS BSS invitation (identified through GPs) What does the study involve? Participants are randomly allocated to one of three groups: 1. Usual care: no contact from GPs 2. Primer and self-referral letter: A letter advising of the future delivery of a BSS invitation is sent by the participant’s GP, along with a locally tailored leaflet explaining the test. If the practice receives notice that an individual did not attend their appointment, a letter highlighting the self-referral process is sent. 3. Primer and patient navigation: As above, a letter and leaflet are sent ahead of the NHS BSS invitation. If the practice receives notice that an individual did not attend their appointment, a call to the participant is made to identify and address personal barriers to uptake and, if appropriate, help arrange a new appointment. If no telephone contact is possible, a self-referral letter is sent. Screening attendance is monitored and compared between the groups.

DISEASE(S): Bowel Cancer

PROVIDER: 2411894 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Background and study aims Colorectal cancer (CRC, also known as bowel cancer) is the fourth most common cancer and the second leading cause of cancer related deaths in England. Screening the at risk population for CRC by way of biennial faecal occult blood testing (FOBt) reduces CRC deaths by detecting CRC early, at a time when it is easier to treat. In England, the National Health Service (NHS) runs an organised population-based CRC screening programme (Bowel Cancer Screening Programme, BCSP), which offers biennial screening via guaiac-based faecal occult blood testing (gFOBt) to any men and women aged 60-74. With 54% overall uptake, CRC screening has the lowest uptake rate amongst all of the organised National Cancer Screening Programmes (Breast and Cervical Cancer Screening) in England. As such, there is an important need for interventions to promote uptake of FOBt in the capital to reduce inequalities in uptake. Increasing evidence demonstrates that General Practitioner (GP) endorsement promotes CRC screening uptake and there is a growing interest in the use text-message reminders to increase participation in cancer screening. The present study aims to investigate the effectiveness of a primary care based text-message reminder to promote CRC screening uptake in London. Who can participate? Adults aged between 60 to 75 who are eligible for bowel cancer screening. What does the study involve? Participants are randomly allocated to one of two groups. Participants are sent an invitation letter with screening information booklet by their local Hub. They then receive the gFOBt kit and instructions 8-10 days letter. They are asked to collect samples of three separate bowel motions and send the completed kit back to the hub. A letter is sent after four weeks of non-response. Those allocated to the first group receive a text message reminder to send their kit back. Those in the second group receive the standard screening materials. Uptake in both groups will be measured at 18 weeks and compared for statistically significant differences.

Project description:Interventions: Eligible people (n = 240) within the SCOOP program (a colonoscopy surveillance program for individuals at higher risk for bowel cancer) at Repatriation General Hospital or Flinders Medical Centre who do not screen for bowel cancer via the standard means (ie. faecal testing), will be sent a letter to invite them to screen for bowel cancer with a blood test (Colovantage Plasma), as well as a short survey to ascertain their demographic details and their screening history. Anyone interested in taking up the blood screening test will be asked to fill in the consent form and request form and send them back (in the provided reply paid envelope) to the Bowel Health Service. Following receipt of the blood test request form, the study enrolee will then be sent further information on the blood test (including information on the accuracy of the test, where they can get their blood collected, and when they will receive their test results) and a test referral. They can then take up the offer of the free screening blood test at one of four local blood collection centres (Healthscope). They do not need to be fasted and appointments do not need to be made. Reminder letters will be sent after 6 weeks to those people who have not taken up the blood test screening offer. Screening participation rate with the blood test and demographic factors that influence uptake, will be assessed at the 12 week time point. Primary outcome(s): The primary outcome is to determine how many people within 12 weeks following the invitation letter have a blood sample collected for bowel cancer screening (ie. outcome = blood test participation rate). The number that complete the blood test will be expressed as a percentage of the invited cohort (ie. 240)[12 weeks after invitation to screen.];An additional primary outcome will be to determine the factors that predict screening uptake with the blood test, ie. age, gender, risk status for bowel cancer, reasons for not participating with faecal testing. This information will be established via a short survey (designed specifically for this study) that is provided with the original study invitation letter.[12 weeks after invitation to screen.] Study Design: Purpose: Prevention; Allocation: Non-randomised trial

Project description:Interventions: Name of intervention: gender specific mail-administered screening invitation strategies. All participants will receive an offer to participate in a free FOBT which will be delivered by mail. Intervention arms will differ from control according to the information included in the materials accompanying the screening offer. All study participants will receive a standard screening reminder irrespective of their intervention group. Intervention materials will target specific psychosocial variables previously identified as being related to male participation in FOBT screening. The intervention period is 14 weeks. All participants will receive a screening offer according to the following timeline. Baseline: Advance notification letter sent Week two: Invitation package sent Week eight: Reminder letters sent to those who have not completed an FOBT Week 14: Data collection ceases. Arm 1: Control The control arm will receive a standard offer to participate in FOBT screening designed to mimic the strategy utilised by the Australian national bowel cancer screening program (NBCSP). The standard offer includes an advance notification letter and a screening invitation package. The advance notification letter is sent two weeks prior to the screening invitation package and is designed to alert participants that an invitation to screen for CRC with an FOBT will soon follow. The standard advance notification letter introduces basic information about colorectal cancer and the health benefits of screening. The screening invitation package includes a) a screening invitation letter b) an immunochemical FOBT with associated instructions c) an information booklet that describes colorectal cancer and screening and d) a particip Primary outcome(s): Rate of FOBT participation per trial arm as assessed by number of FOBT screening tests returned.[At 14 weeks from baseline, 12 weeks after receiving the FOBT.] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Factorial;Type of endpoint: Efficacy

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Bowel scope screening: interventions to increase uptake in Yorkshire

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