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NEWS: Roger Dobson Pilot of bowel cancer screening shows lower uptake in second round BMJ 2007; 335: 1115 [Full text]

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Increasing Bowel Cancer Screening Uptake in the UK

Michael Gordon   (10 December 2007)

Increasing Bowel Cancer Screening Uptake in the UK 10 December 2007
Michael Gordon, General Practitioner Gleadless Medical Centre, 636 Gleadless Road, Sheffield, S14 1PQ Send response to journal: Re: Increasing Bowel Cancer Screening Uptake in the UK	Low uptake of colorectal cancer screening in deprived communities is an established problem and the UK screening pilot second round results come as no surprise.1 Hardcastle et al demonstrated the phenomenon at practice level in their seminal RCT.2 The question of what to do about it remains unanswered in the UK. Much work has been done to address the issue in the US where interventions aimed at particular subgroups have achieved the most impressive increases in uptake when they are multicomponent e.g. involving calendars, posters, brochures and instructional handouts or a combination of information booklet, telephone reminder and instructional call.3;4 One of the few European intervention studies showed an increase from 36.5% to 57.7% with a simple delivery and collection service.5 Primary care and GPs in particular continue to enjoy a position of influence in most communities and as such endorsement of the programme by them may increase uptake. In Australia including explicit written support for the programme by local GPs in the programme documentation, led to an increase in participation from 35.2% to 41.8%.6 Ongoing qualitative research in South Yorkshire suggests that GPs would welcome involvement in the programme where their endorsement may be valuable. Engagement of general practice may deliver considerable benefits for very little additional work and programme organisers should make full use of general practice influence especially in areas of high deprivation and corresponding low uptake. Reference List (1) Weller D, Coleman D, Robertson R, Butler P, Melia J, Campbell C et al. The UK colorectal cancer screening pilot: results of the second round of screening in England. British Journal of Cancer [ 2007 [cited 2007 Dec. 4]; (2) Hardcastle JD, Chamberlain JO, Robinson MH, Moss SM, Amar SS, Balfour TW et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 1996; 348(9040):1472-1477. (3) Powe BD. Promoting fecal occult blood testing in rural African American women. Cancer Pract 2002; 10(3). (4) Myers RE, Ross EA, Wolf TA, Balshem A, Jepson C, Millner L. Behavioral Interventions to Increase Adherence in Colorectal-Cancer Screening. Med Care 1991; 29(10):1039-1050. (5) Courtier R, Casamitjana M, Macia F, Panades A, Castells X, Gil MJ et al. Participation in a colorectal cancer screening programme: influence of the method of contacting the target population. Eur J Cancer Prev 2002; 11(3):209-213. (6) Cole SR, Young GP, Byrne D, Guy JR, Morcom J, Cole SR et al. Participation in screening for colorectal cancer based on a faecal occult blood test is improved by endorsement by the primary care practitioner. J Med Screen 2002; 9(4):147-152. Competing interests: None declared