Strategies to reduce the social gradient in bowel cancer screening: the ASCEND project
Ontology highlight
ABSTRACT:
DISEASE(S): Colorectal Cancer
PROVIDER: 2422925 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
Similar Datasets
Project description:Background and study aims
Bowel cancer is the second most common cause of cancer death in the UK. Early diagnosis improves survival and in light of this the NHS established the Bowel Cancer Screening Programme (BCSP). This Programme offers screening using a stool testing kit (the faecal occult blood test) to 60-74 year olds. Data from 2012 shows that only 53% of those offered screening take it up and that this varies from more than 60% in the most socially advantaged areas of the country to less than 35% in the most disadvantaged areas. This study aims to increase uptake in the BCSP, and to reduce differences in uptake between the most and least socially advantaged groups, whilst ensuring that uptake does not decline in any socioeconomic (SE) group. The study will test whether or not receiving an endorsement from your GP at the same time that you receive a kit as part of the BCSP is likely to increase uptake and/or reduce SE inequalities.
Who can participate?
Individuals who are routinely invited for screening in the BCSP (age 60-74 with a registered GP).
What does the study involve?
Participants will be randomly allocated either to receive an invitation letter with a GP endorsement or the standard letter currently sent out by the BCSP without an endorsement.
| 2408955 | ecrin-mdr-crc
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.
| 2422356 | ecrin-mdr-crc
Project description:Background and study aims
Bowel cancer screening uptake has traditionally been lower than the government would like it to be. As screening can spot early signs of cancer and even stop bowel cancer from occurring, the public health service would like to improve screening rates.
This study aims to test a set of new, evidence-based materials, informed by psychological theory, to increase the return of the stool-based bowel cancer screening kit the NHS uses, in the North East region of England.
Who can participate?
Adults age 60 – 74 years eligible for bowel cancer screening
What does the study involve?
Participants are randomly allocated to one of four groups. All participants are sent an initial invitation letter for bowel cancer screening and the standard NHS information booklet.
Those in the first group receive an intervention pack four days after the letter, with an information sheet and short paper based task encouraging them to connect barriers likely to be encountered with effective responses. They receive the bowel cancer screening test four days later.
Participants in the second group receive an intervention pack containing the information sheet and a motivational leaflet. They receive the screening kit in the post four days later.
Participants in the third group receive both of the above intervention packs in the post four days after the initial letter, before the screening kit four days later.
Participants in the last group receive no additional information, and get a screening kit in the post eight days after the initial letter.
| 2416973 | ecrin-mdr-crc
Project description:Background and study aims
Bowel cancer is a leading cause of cancer-related death in England. Several large studies have shown that screening can improve bowel cancer outcomes by detecting cases early. In light of this, NHS England initiated a national bowel cancer screening programme (BCSP) in 2006. Since then, uptake has been consistently low, falling from 54% in 2010 to 49% in 2015. Further, in London, participation in bowel cancer screening is particularly low in regions where there is high ethnic diversity.
However, previous research suggests that it is possible to improve screening uptake by using text message reminders and patient navigation (one-to-one support and guidance for patients throughout their decision-making regarding screening). This study aims to compare the effectiveness, and cost-effectiveness, of these two strategies to increase bowel cancer screening participation in six areas in London, where screening uptake is known to be low. This will provide policy-decision makers with the information needed to commission these services.
Who can participate?
Men and women aged 60-74 years registered with a participating general practice located within the London Boroughs of Brent, Ealing, Lambeth, Lewisham, Redbridge and Barking and Dagenham, who have not returned a bowel cancer screening kit within 13 weeks of delivery
What does the study involve?
Over a 4-week period, participants will be allocated (at random) to groups receiving either usual care, text message reminders at 13, 15, 17,19 weeks of non-response, or a text message reminder at 13 weeks plus patient navigation at 15, 17, 19 weeks of non-response.
| 48380 | ecrin-mdr-crc
Project description:High uptake is vital to population-based screening. BowelScreen (Irelands national organised population-based colorectal cancer screening programme) has not achieved recommended screening uptake targets. In Ireland sending the test kit in the screening invitation reminder may be an important strategy in targeting non-responders and would address a key difference between Ireland and other international screening programmes with higher uptake. In addition, few studies have focused on behavioural barriers to screening participation. Founded upon the MRC Guidelines for the Development of Complex Interventions, our systematic, theoretically-informed investigation of FIT screening participation has begun to identify behavioural antecedents to screening participation in Ireland. This study will implement a multilevel evidence-based, theoretically-informed intervention which includes the automatic inclusion of the test kit in the screening reminder, alone and in combination with an intervention to influence individuals’ screening participation. This multilevel intervention will provide recommendations for the screening invitation delivery, potentially bringing the programme closer to recommended uptake targets (50%) and in the long-term influence reductions in bowel cancer incidence and mortality in Ireland.
| 2760785 | ecrin-mdr-crc
Project description:The aim of this study is to demonstrate the effectiveness of three and four-staged invitation procedures compared to two-staged procedures by combining pre-notifications and reminders. The RCT will be nested into the Danish colorectal cancer screening programme in the Central Denmark Region including men and women aged 50-74 years. Participants will consecutively be randomized into four arms in a 1:1 ratio. Intervention arm 1 will receive a pre-notification approximately ten days prior to intervention, invitation and one reminder (three-staged intervention), Intervention arm 2 will receive invitation, one reminder after 45 days and a second reminder three months after invitation (three-staged invitation procedure), Intervention arm 3 will receive pre-notification, invitation, reminder after 45 days and reminder after three months (four-staged invitation procedure). Finally, the forth arm will be a control group receiving usual care which invitation and one reminder 45 days after invitation (two-staged invitation procedure). Both pre-notifications and reminders are sent using digital mail.
The main out-come will be participation within 6 months after invitation.
| 2331858 | ecrin-mdr-crc
Project description:Background and study aims
In England, the NHS Bowel Cancer Screening Programme (BCSP) offers screening to over 60 year olds. This involves completing a stool sample test at home. Recent data suggests that only 1 in 2 people who are offered the test, go on to complete it. However, this figure varies from more than 60% in the most socially advantaged groups to less than 35% in the most disadvantaged groups. The aim of this study is to reduce this difference in uptake rates between social groups. This study aims to test the effect of a leaflet by assessing its impact on participants intentions to use the test in a group of adults approaching the age of screening.
Who can participate?
Men and women aged between 45 to 59 and half years, who can read and write English.
What does the study involve?
The study involves sending all potential participants a study pack. The pack contains a covering letter from the participants GP practice, an 8-page questionnaire, a freepost return envelope, and an NHS envelope containing an example of the NHS BCSP invitation letter and a facts booklet about bowel cancer screening. For half of the participants, a narrative leaflet will also be included in the NHS envelope. Participants will be asked to read the contents of the NHS envelope before completing and returning the questionnaire in the freepost envelope to the research team.
| 2423005 | ecrin-mdr-crc
Project description:Background and study aims:
Colorectal (bowel) cancer is the second leading cause of cancer death in the UK, and costs the National Health Service (NHS) more than £300 million a year in treatment costs. Patient survival could be increased and, costs very much reduced, if patients with bowel cancer received their diagnosis earlier, allowing treatment to begin earlier. The NHS Bowel Cancer Screening Programme (NHSBCSP) was introduced in England in 2006, and aims to screen men and women aged between 60 to 74 years of age for bowel cancer every two years using the faecal occult blood test (FOBt). Initial studies have shown that bowel screening is effective, but the number of patients who participate in screening have been quite low, with only around half of all the people who are invited to participate returning their FOBt kit.
The success of the NHSBCSP relies on a high number of patients participating, and the development of new ways to improve the number participating after they are invited to participate.
The main aim of the study is to assess how effective a GP reminder and additional FOBt kit are on increasing the number who participate in bowel cancer screening, when they have not participated following a previous invitation.
Who can participate?
All adults eligible for bowel screening (aged between 60 to 74 years old). These were patients at a participating general practice in the West Midlands, where the screening rate is less than 50%. These patients had been invited to participate in bowel screening but had not returned their FOBt within 13 weeks of initial invitation by the Midlands and North West Bowel Cancer Screening Hub.
What does the study involve?
We will randomly allocate the participants to one of two groups:
1. GP reminder to participate in bowel screening and additional FOBt kit, OR
2. No additional contact
We compared how may people participated in bowel screening after 13 weeks. This was measured by the number of FOBt kits that were returned to the bowel screening hub by patients in each group. This allowed us to assess if the GP reminder to participate in bowel screening and additional FOBt kit was successful in increasing the participation in bowel screening. A small interview was carried out with some patients who received the GP reminder who returned a FOBt kit.
| 2425164 | ecrin-mdr-crc
Project description: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.
| 2411894 | ecrin-mdr-crc
Project description:The objective of this research is to investigate whether a text message (SMS message) prompting participation in the UK national bowel cancer screening programme improves uptake for those who have not responded to the test.
The secondary objective is to investigate whether the framing/phrasing of the text message improves participation , whether by stating the benefits of uptake or alternatively by stating the costs of non-uptake.
| 2270040 | ecrin-mdr-crc