Introduction There is wide variation in uptake of bowel cancer screening in England. Areas with a high index of multiple deprivation (IMD) score (more deprived) have lower uptake than areas with low IMD (less deprived). Initiatives to raise awareness of bowel cancer and screening have been sporadic and have not been sustained. Previous studies have demonstrated endorsement by a general practitioner (GP) can increase uptake of bowel cancer screening.
The Bowel Cancer Screening Programme (BCSP) Southern Hub is piloting a sustainable intervention to engage subjects in bowel cancer screening by exploiting GP patient knowledge and the Hub’s established procedures for communication - the PEARL (Practice Endorsed Additional Reminder Letter) project.
Method Practices participating in the project supplied the Hub with a letterhead and GP signature. A computer program was developed to interrogate the BCSP database and identify subjects in those practices who had not participated in screening within 30 days after the standard reminder letter. The list of non-participants was e-mailed to each practice for GPs to identify subjects not suitable for the GP reminder letter (e.g.subjects in receipt of end-of-life-care, unable to have colonoscopy). The list was returned to the Hub and checked again to exclude recent responders and any subjects who had died. Subjects on the final list received an approved GP-endorsed reminder letter on headed and signed stationery. Practices returning three lists received a financial reward.
Results Forty-six practices with uptake <55% were invited to participate and 25 accepted. Between September 2014–January 2015, 2,370 subjects were identified as non-responders and 1,433 received a GP-endorsed reminder letter. Seventy-seven subjects were excluded by their GP, 853 subjects were on lists not returned to the Hub and three practices failed to return any lists.
Conclusion We have developed a robust and sustainable system to send GP-endorsed reminder letters to non-responders. The pilot will now be extended to assess the impact on screening uptake and explore factors that will improve GP engagement. The pilot will assess the viability of national adoption within the BCSP.
Disclosure of interest None Declared.
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