Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/30127
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dc.contributor.authorRaine, Rosalinden_UK
dc.contributor.authorMoss, Sue Men_UK
dc.contributor.authorvon Wagner, Christianen_UK
dc.contributor.authorAtkin, Wendyen_UK
dc.contributor.authorKralj Hans, Inesen_UK
dc.contributor.authorHowe, Rosemaryen_UK
dc.contributor.authorSolmi, Francescaen_UK
dc.contributor.authorMorris, Stephenen_UK
dc.contributor.authorCounsell, Nicholasen_UK
dc.contributor.authorHackshaw, Allanen_UK
dc.contributor.authorHalloran, Stephenen_UK
dc.contributor.authorHandley, Grahamen_UK
dc.contributor.authorLogan, Richard Fen_UK
dc.contributor.authorRainbow, Sandraen_UK
dc.contributor.authorMcGregor, Lesley Men_UK
dc.date.accessioned2019-09-20T00:05:30Z-
dc.date.available2019-09-20T00:05:30Z-
dc.date.issued2016-12-06en_UK
dc.identifier.urihttp://hdl.handle.net/1893/30127-
dc.description.abstractBackground: The NHS Bowel Cancer Screening Programme in England offers biennial guaiac faecal occult blood testing (gFOBt). There is a socioeconomic gradient in participation and socioeconomically disadvantaged groups have worse colorectal cancer survival than more advantaged groups. We compared the effectiveness and cost of an enhanced reminder letter with the usual reminder letter on overall uptake of gFOBt and the socioeconomic gradient in uptake. Methods: We enhanced the usual reminder by including a heading ‘A reminder to you’ and a short paragraph restating the offer of screening in simple language. We undertook a cluster-randomised trial of all 168 480 individuals who were due to receive a reminder over 20 days in 2013. Randomisation was based on the day of invitation. Blinding of individuals was not possible, but the possibility of bias was minimal owing to the lack of direct contact with participants. The enhanced reminder was sent to 78 067 individuals and 90 413 received the usual reminder. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. Data were analysed by logistic regression with conservative variance estimates to take account of cluster randomisation. Results: There was a small but statistically significant (P=0.001) increase in participation with the enhanced reminder (25.8% vs 25.1%). There was significant (P=0.005) heterogeneity of the effect by socioeconomic status with an 11% increase in the odds of participation in the most deprived quintile (from 13.3 to 14.1%) and no increase in the least deprived. We estimated that implementing the enhanced reminder nationally could result in up to 80 more people with high or intermediate risk colorectal adenomas and up to 30 more cancers detected each year if it were implemented nationally. The intervention incurred a small one-off cost of £78 000 to modify the reminder letter. Conclusions: The enhanced reminder increases overall uptake and reduces the socioeconomic gradient in bowel cancer screening participation at little additional cost.en_UK
dc.language.isoenen_UK
dc.publisherCancer Research UKen_UK
dc.relationRaine R, Moss SM, von Wagner C, Atkin W, Kralj Hans I, Howe R, Solmi F, Morris S, Counsell N, Hackshaw A, Halloran S, Handley G, Logan RF, Rainbow S & McGregor LM (2016) A national cluster-randomised controlled trial to examine the effect of enhanced reminders on the socioeconomic gradient in uptake in bowel cancer screening. British Journal of Cancer, 115, pp. 1479-1486. https://doi.org/10.1038/bjc.2016.365en_UK
dc.rightsFrom twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ © 2019 Springer Nature Limiteden_UK
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/en_UK
dc.titleA national cluster-randomised controlled trial to examine the effect of enhanced reminders on the socioeconomic gradient in uptake in bowel cancer screeningen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1038/bjc.2016.365en_UK
dc.identifier.pmid27875518en_UK
dc.citation.jtitleBritish Journal of Canceren_UK
dc.citation.issn1532-1827en_UK
dc.citation.issn0007-0920en_UK
dc.citation.volume115en_UK
dc.citation.spage1479en_UK
dc.citation.epage1486en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderNational Institute for Health Researchen_UK
dc.citation.date22/11/2016en_UK
dc.description.notesAdditional co-authors: Steve Smith, Julia Snowball, Helen Seaman, Mary Thomas, Samuel G Smith, Gemma Vart, Jane Wardle & Stephen W Duffyen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationQueen Mary, University of Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationImperial College Londonen_UK
dc.contributor.affiliationKing's College Londonen_UK
dc.contributor.affiliationImperial College Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationUniversity of Surreyen_UK
dc.contributor.affiliationGateshead Health NHS Foundation Trusten_UK
dc.contributor.affiliationUniversity of Nottinghamen_UK
dc.contributor.affiliationNorthwest London Hospitals NHS Trusten_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.identifier.isiWOS:000390760300008en_UK
dc.identifier.scopusid2-s2.0-84996956337en_UK
dc.identifier.wtid1399368en_UK
dc.contributor.orcid0000-0002-7093-1391en_UK
dc.date.accepted2016-10-13en_UK
dcterms.dateAccepted2016-10-13en_UK
dc.date.filedepositdate2019-09-13en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorRaine, Rosalind|en_UK
local.rioxx.authorMoss, Sue M|en_UK
local.rioxx.authorvon Wagner, Christian|en_UK
local.rioxx.authorAtkin, Wendy|en_UK
local.rioxx.authorKralj Hans, Ines|en_UK
local.rioxx.authorHowe, Rosemary|en_UK
local.rioxx.authorSolmi, Francesca|en_UK
local.rioxx.authorMorris, Stephen|en_UK
local.rioxx.authorCounsell, Nicholas|en_UK
local.rioxx.authorHackshaw, Allan|en_UK
local.rioxx.authorHalloran, Stephen|en_UK
local.rioxx.authorHandley, Graham|en_UK
local.rioxx.authorLogan, Richard F|en_UK
local.rioxx.authorRainbow, Sandra|en_UK
local.rioxx.authorMcGregor, Lesley M|0000-0002-7093-1391en_UK
local.rioxx.projectProject ID unknown|National Institute for Health Research|http://dx.doi.org/10.13039/501100000272en_UK
local.rioxx.freetoreaddate2019-09-19en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by-nc-sa/4.0/|2019-09-19|en_UK
local.rioxx.filenamebjc2016365.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source1532-1827en_UK
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