Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial
2011

Improving Participation in Colorectal Cancer Screening

Sample size: 1288 publication 10 minutes Evidence: moderate

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)

10.1038/bjc.2011.255

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication