Improving Participation in Colorectal Cancer Screening
Author Information
Author(s): Hewitson P, Ward A M, Heneghan C, Halloran S P, Mant D
Primary Institution: Department of Primary Health Care, University of Oxford
Hypothesis
Does a GP's endorsement letter and an enhanced information leaflet improve participation in colorectal cancer screening?
Conclusion
Including both an endorsement letter from each patient's GP and a more explicit procedural leaflet could increase participation in the English Bowel Cancer Screening Programme by approximately 10%.
Supporting Evidence
- Both the GP's endorsement letter and the enhanced procedural leaflet increased participation by approximately 6%.
- The GP's letter increased participation by 5.8% and the leaflet by 6.0%.
- An additive effect was confirmed when both interventions were used together, increasing participation by 11.8%.
- Participants receiving a signed GP's letter had a higher participation rate (64.9%) compared to those with a non-signed letter (54.1%).
Takeaway
Sending a letter from your doctor and a helpful leaflet can make more people take part in bowel cancer screening tests.
Methodology
A 2 × 2 factorial randomised controlled trial was conducted with 1288 patients invited for screening.
Potential Biases
Potential for a priming effect due to advance notification of the trial.
Limitations
Patients could opt-out after randomisation, leading to slight imbalances in intervention groups.
Participant Demographics
Participants were men and women aged 60–75 years registered with GPs in southern England.
Statistical Information
P-Value
P=0.038 for GP's letter, P=0.029 for leaflet
Confidence Interval
95% CI: 4.1–7.8% for GP's letter, 95% CI: 4.3–8.1% for leaflet
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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