NHS bowel scope uptake boosted by a fifth when patients sent reassuring reminders

January 15, 2018, Cancer Research UK

Bowel scope screening uptake increased by more than a fifth (21.5%) when people were sent additional reminders with a leaflet that addressed common concerns, according to a new study funded by Cancer Research UK.

The NHS bowel scope screening programme is gradually being rolled out in England to men and women aged between 55 and 59, prior to the bowel screening programme offered at 60. It is a one-off, preventative and diagnostic test where a tiny camera is inserted into the bowel allowing doctors to find and remove any small bowel growths, called polyps, which could eventually turn into cancer.

The reminder letters, sent one and two years after the initial invitation, allowed people to choose the time of their appointment and the gender of the doctor performing the test.

The researchers found that the main concerns about the test included embarrassment, pain and fear of harm to the bowel. The leaflet, created by the researchers from University College London (UCL) with help from the public, included patient testimonials and advice from a named and pictured local GP to address this.

An invitation with an NHS information booklet and an appointment time is sent to the NHS-registered population at 55 years old. It is up to the recipient to confirm and attend their appointment. At two weeks, there is a further reminder to confirm the appointment. Around 40% of people attend their appointments with this system.

Dr Robert Kerrison, lead researcher from University College London said: "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. Providing information targeting the concerns of patients is one way to break down the barriers to bowel scope screening uptake."

Dr Jodie Moffat, Cancer Research UK's head of early diagnosis said: "Cancer 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. Studies such as this help us learn about the best way to provide information in a way that resonates with people and ensures we can minimise any unnecessary barriers to people taking part. To fully realise the potential of we need a system that adopts research findings into practice and has enough of the right workforce to deliver what's needed."

Bowel cancer is the 4th most common cancer in the UK and over half of cases are diagnosed at a late stage in England.

The study is published today in the Annals of Behavioral Medicine.

Explore further: One-off bowel scope cuts cancer risk for at least 17 years

More information: Kerrison et al. Use of two self-referral reminders and a theory-based leaflet to increase the uptake of flexible sigmoidoscopy in the English Bowel Scope Screening Programme: results from a randomised controlled trial in London. Annals of Behavioral Medicine (2018). DOI: 10.1093/abm/kax068

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