To Increase Adherence to Screening, Just Make the Patient an Appointment

In England, colorectal cancer screening is done using guaiac-based fecal occult blood testing. Flexible sigmoidoscopy at age ≥55 years is also being introduced. In a pilot study of the flexible sigmoidoscopy program, investigators assessed patient adherence to multiple screening invitation processes.

At one screening center, eligible people were mailed a health questionnaire and asked to return it to the center. If patients passed the screening questionnaire, they were contacted to book a flexible sigmoidoscopy appointment. In a second center, a letter invited patients to contact the screening center and book a telephone assessment, after which a flexible sigmoidoscopy appointment was made if they were deemed eligible. In a third center, patients were sent an invitation letter that included an appointment date and time for flexible sigmoidoscopy; they were asked to respond to the center if interested.

The proportion of invited patients who participated in screening was 32% in the center that made the screening appointment up front versus 27% in the other two centers combined (P=0.0015).