Implementation of long-term non-participant reminders for flexible sigmoidoscopy screening

• Main Authors: R.S. Kerrison, A. Prentice, S. Marshall, S. Choglay, S. Stoffel, C. Rees, C. von Wagner
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: Preventive Medicine Reports
• Subjects: Flexible sigmoidoscopy screening; Colorectal cancer screening; Bowel scope screening; Reminders; Uptake
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211335520302667

The clinical effectiveness of screening is highly dependent on uptake. Previous randomised controlled trials suggest that non-participant reminders, which highlight the opportunity to re-book an appointment, can improve participation. The present analysis examines the impact of implementing these reminders within the English Flexible Sigmoidoscopy (FS) Screening Programme, which offers once-only FS screening to adults aged 55–59 years.We assessed the screening status of 26,339 individuals invited for once-only FS screening in England. A total of 10,952 (41.6%) had attended screening, and were subsequently ineligible. The remaining 15,387 had not attended screening, and were selected to receive a reminder, 1–2 years after their invitation. Descriptive statistics were used to assess the increase in uptake and the adenoma detection rate (ADR) of those who self-referred, six months after the delivery of the final reminder. Pearson’s Chi-Square was used to compare the ADR between those who attended when invited and those who self-referred.Of the 15,387 adults eligible to receive a reminder, 13,626 (88.6%) were sent a reminder as intended (1,761 were not sent a reminder, due to endoscopy capacity). Of these, 8.0% (n = 1,086) booked and attended an appointment, which equated to a 4.1% increase in uptake from 41.6% at baseline, to 45.7% at follow-up. The ADR was significantly higher for those who self-referred, compared with those who attended when invited (13.3% and 9.5%, respectively; X2 = 16.138, p = 0.000059).The implementation of non-participant reminders led to a moderate increase in uptake. Implementing non-participant reminders could help mitigate the negative effects of COVID-19 on uptake.