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Second reminder improves uptake in colon cancer screenings
Patients in the U.K. were more likely to undergo flexible sigmoidoscopy screening if they received a second follow-up reminder that included a brochure that addressed common concerns about the procedure, according to a study published in The Annals of Behavioral Medicine.
Robert Kerrison, MD, of the research department of behavioral science and health at University College in London, and colleagues wrote that their findings highlight the value of a “theory-based” brochure, and could help develop common practices that ensure more people undergo these screenings.
“Despite bowel scope screening attendance being low where it has been rolled out so far, this research shows that more could be done to improve uptake,” Kerrison said in a press release. “Providing information targeting the concern of patients is one way to break down the barriers to bowel scope screening uptake.”
The National Health Service in the United Kingdom started offering flexible sigmoidoscopies to people aged between 55 and 59 years as a preventive measure against colorectal cancer. Although the appointments are made automatically following a person’s 55th birthday, and the procedure is entirely free, only 43% of people took advantage of the program, according to the study.
Researchers performed a single-blind, randomized, controlled trial of 1,383 patients to test methods to remove the barriers to the screening, which included concerns about pain and even embarrassment about having the test.
Patients who already received their initial invitation but failed to be screened were then split up into three groups; the control group (n = 461) was given no reminders about the procedure, a second group (n = 461) was given a reminder and the same information booklet they received when they were first notified of their appointment, and a third group (n = 461) was given a reminder with a “theory-based” booklet that had testimonials from former patients and endorsements from primary care physicians to alleviate the fears of potential patients. Overall, 8.6% completed screening after first reminders were sent out at 1 year.
Of the 1,218 non-responders who were then sent an additional reminder at 2 years, 4.1% then completed screening.
Additional uptake in the program increased by 0.4% in the control group, 4.8% in the second group and 7.9% in the third group after the second reminders were sent. Overall uptake was higher in the groups that received a reminder compared with the control group, and the group that received the “theory-based” brochure had higher uptake than the group that received the standard booklet (OR = 1.8, 95% CI = 1.3-2.6).
Jodie Moffat, PhD, head of early diagnosis for the non-profit group Cancer Research UK, said the study will help inform medical professionals about the best ways to inform people and encourage them to get bowel screenings.
“Cancer screening offers a lot of potential for reducing the burden of cancer but there are harms as well as benefits, so it’s important that people make their own decision about whether to take part or not,” she said in the press release. “To fully realize the potential of cancer screening we need a system that adopts research findings into practice and has enough of the right workforce to deliver what’s needed.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.