Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/44458
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Type: Journal article
Title: An advance notification letter increases participation in colorectal cancer screening
Author: Cole, S.
Smith, A.
Wilson, C.
Turnbull, D.
Esterman, A.
Young, G.
Citation: Journal of Medical Screening, 2007; 14(2):73-75
Publisher: British Med Journal Publ Group
Issue Date: 2007
ISSN: 0969-1413
1475-5793
Statement of
Responsibility: 
S R Cole, A Smith, CWilson, D Turnbull, A Esterman and G P Young
Abstract: Objectives: To determine the impact of novel invitation strategies on population participation in faecal immunochemical test (FIT)-based colorectal cancer (CRC) screening. Setting A community screening programme in Adelaide, South Australia. Methods: In total, 2400 people aged 50–74 years were randomly allocated to one of four CRC screening invitation strategies: (a) Control: standard invitation-to-screen letter explaining risk of CRC and the concept, value and method of screening; (b) Risk: invitation with additional messages related to CRC risk; (c) Advocacy: invitation with additional messages related to advocacy for screening from previous screening programme participants and (d) Advance Notification: first, a letter introducing Control letter messages followed by the standard invitation-to-screen. Invitations included an FIT kit. Programme participation rates were determined for each strategy relative to control. Associations between participation and sociodemographic variables were explored. Results: At 12 weeks after invitation, participation was: Control: 237/600 (39.5%); Risk: 242/600 (40.3%); Advocacy: 216/600 (36.0%) and Advance Notification: 290/600 (48.3%). Participation was significantly greater than Control only in the Advance Notification group (Relative risk [RR] 1.23, 95% confidence interval [CI] 1.06–1.43). This effect was apparent as early as two weeks from date of offer; Advance Notification: 151/600 (25.2%) versus Control: 109/600 (18.2%, RR 1.38, 95% CI 1.11–1.73). Conclusions: Advance notification significantly increased screening participation. The effect may be due to a population shift in readiness to undertake screening, and is consistent with the Transtheoretical Model of behaviour change. Risk or lay advocacy strategies did not improve screening participation. Organized screening programmes should consider using advance notification letters to improve programme participation.
Keywords: Humans; Colorectal Neoplasms; Mass Screening; Reproducibility of Results; Time Factors; Aged; Middle Aged; Patient Participation; Patient Acceptance of Health Care; South Australia
Description: © 2007 Royal Society of Medicine
RMID: 0020073032
DOI: 10.1258/096914107781261927
Appears in Collections:Psychology publications

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