Kerrison R S, Prentice A, Marshall S, Choglay S, Stoffel S, Rees C, von Wagner C
Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom.
St Mark's Bowel Cancer Screening Centre, St Mark's Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, United Kingdom.
Prev Med Rep. 2021 Jan 4;21:101308. doi: 10.1016/j.pmedr.2020.101308. eCollection 2021 Mar.
The clinical effectiveness of screening is highly dependent on uptake. Previous randomised controlled trials suggest that non-participant reminders, which highlight the opportunity to re-book an appointment, can improve participation. The present analysis examines the impact of implementing these reminders within the English Flexible Sigmoidoscopy (FS) Screening Programme, which offers once-only FS screening to adults aged 55-59 years. We assessed the screening status of 26,339 individuals invited for once-only FS screening in England. A total of 10,952 (41.6%) had attended screening, and were subsequently ineligible. The remaining 15,387 had not attended screening, and were selected to receive a reminder, 1-2 years after their invitation. Descriptive statistics were used to assess the increase in uptake and the adenoma detection rate (ADR) of those who self-referred, six months after the delivery of the final reminder. Pearson's Chi-Square was used to compare the ADR between those who attended when invited and those who self-referred. Of the 15,387 adults eligible to receive a reminder, 13,626 (88.6%) were sent a reminder as intended (1,761 were not sent a reminder, due to endoscopy capacity). Of these, 8.0% (n = 1,086) booked and attended an appointment, which equated to a 4.1% increase in uptake from 41.6% at baseline, to 45.7% at follow-up. The ADR was significantly higher for those who self-referred, compared with those who attended when invited (13.3% and 9.5%, respectively; = 16.138, = 0.000059). The implementation of non-participant reminders led to a moderate increase in uptake. Implementing non-participant reminders could help mitigate the negative effects of COVID-19 on uptake.
筛查的临床效果高度依赖于参与率。以往的随机对照试验表明，强调重新预约机会的非参与者提醒可以提高参与率。本分析研究了在英国柔性乙状结肠镜检查（FS）筛查项目中实施这些提醒的影响，该项目为55 - 59岁的成年人提供一次性FS筛查。我们评估了在英国被邀请参加一次性FS筛查的26339人的筛查状态。共有10952人（41.6%）参加了筛查，随后不符合再筛查条件。其余15387人未参加筛查，并被选中在收到邀请后的1 - 2年收到提醒。使用描述性统计来评估在发出最后提醒六个月后自我转诊者的参与率增加情况以及腺瘤检出率（ADR）。使用Pearson卡方检验比较受邀时参加筛查者和自我转诊者之间的ADR。在15387名有资格收到提醒的成年人中，13626人（88.6%）按计划收到了提醒（1761人由于内镜检查能力原因未收到提醒）。其中，8.0%（n = 1086）预约并参加了检查，这相当于参与率从基线时的41.6%适度增加到随访时的45.7%。与受邀时参加筛查者相比，自我转诊者的ADR显著更高（分别为13.3%和9.5%； = 16.138， = 0.000059）。实施非参与者提醒导致参与率适度增加。实施非参与者提醒有助于减轻COVID - 19对参与率的负面影响。
