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Lookup NU author(s): Professor Linda SharpORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.Background: Many countries have established organized colorectal cancer screening programs because they can reduce mortality and incidence from the disease; however, they rely on high participation rates, which are often suboptimal. This study examined the effectiveness of two reminder interventions on uptake rates in Ireland’s population-based BowelScreen program. Methods: Employing a quasi-experimental design, one intervention mailed the fecal-immunochemical test (FIT) directly to clients not responding to an initial invitation; the other mailed a reminder letter modified with behavioral insights. Interventions were tested separately and in combination and compared to the standard reminder letter (1: standard reminder letter [SRL]; 2: modified reminder letter [MRL]; 3: SRL + FIT direct [FITD]; and 4: MRL + FITD). Primary outcome: overall uptake rate (test completion at 5 months); Subgroup outcome: uptake rate among only those receiving reminders. Outcomes were modeled using multivariable logistic regression with group allocation as a fixed effect, adjusted for sex and deprivation. Results: Uptake was significantly higher in the FITD groups (SRL: 48%; MRL: 50%; SRL + FITD: 54%; MRL + FITD: 54%; p <.001). After adjustment, compared to the SRL group, FITD groups had significantly higher odds of uptake (MRL: odds ratio [OR], 1.09; 95% confidence interval [CI], 0.96–1.23; SRL + FITD: OR, 1.30; 95% CI, 1.14–1.48; MRL + FITD: OR, 1.26; 95% CI, 1.11–1.44). This was also the case for subgroup analysis. The MRL did not result in higher uptake compared to SRL. Conclusion: Mailing the FIT kit directly to nonresponders resulted in improved FIT uptake. Organized FIT-based screening programs not reaching uptake targets should consider implementing this strategy if not already in place.
Author(s): Clarke N, Mooney T, Gallagher P, von Wagner C, Hanly P, McNamara D, Coffey H, Fitzpatrick P, Sharp L
Publication type: Article
Publication status: Published
Journal: Cancer
Year: 2025
Volume: 131
Issue: 7
Print publication date: 01/04/2025
Online publication date: 01/04/2025
Acceptance date: 08/01/2025
Date deposited: 22/04/2025
ISSN (print): 0008-543X
ISSN (electronic): 1097-0142
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1002/cncr.35760
DOI: 10.1002/cncr.35760
Data Access Statement: The data that support the findings of this study are available from the corresponding author on reasonable request.
PubMed id: 40165537
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