New study: Bowel screening uptake boosted with simple change to invitation letter
A new study co-authored by Population and Behavioural Science Division Head Prof. Colin McCowan has found that adding a deadline to bowel screening invitation letters significantly boosted test returns.
Screening by self-sampled faecal immunochemical test (FIT) – offered biennially to people in Scotland aged 50-74 – is known to reduce colorectal cancer mortality. Yet the uptake of such testing, which requires participants to collect and return a stool sample using a kit mailed to their homes, remains low.
The research team, led by the University of Glasgow’s School of Health and Wellbeing, sought to address this issue by assessing the impact of various behavioural interventions on screening uptake rates among 40,000 adults in the Scottish Bowel Screening Programme. They found that adding a single sentence to screening invitation letters, which suggested a deadline for returning one’s sample for testing, led to a statistically significant increase in FIT return rates. The largest effect (a 2% absolute increase) was seen among participants given a two-week deadline.
Prof. McCowan and his co-authors estimate that this 2% increase in FIT return could lead to an additional 39,000 participants in a two-year Scottish Bowel Screening round, potentially preventing approximately 23 colorectal cancer deaths. Moreover, increasing uptake in response to the initial invitation letter reduces the need for reminder letters and alleviates the burden on primary care and public health efforts.
“This long-standing collaboration with researchers at the University of Glasgow and others has identified an effective but simple and cost-free measure shown to improve test return rates across all groups in the population,” said Prof. McCowan.
The study, published in the Lancet on 13 March, underscores the importance of simple, cost-effective behavioural interventions in promoting public health.