This is a summary of independent research funded by the National Institute for Health. Research (NIHR)’s Programme Grants for Applied Research Programme (RP-PG-0609–10106

Allan Hackshaw

C von Wagner

Christian von Wagner

CK Palmer

Francesca Solmi

Gemma Vart

Graham Handley

H White

Ines Kralj-Hans

IT Zajac

J Ferlay

Jane Wardle

JH Scholefield

Julia Snowball

L Camilloni

Lesley M McGregor

Mary C Thomas

MJ Campbell

Nicholas Counsell

P Hewitson

PJ Huber

RFA Logan

Richard F Logan

Rosalind Raine

Rosemary Howe

Samuel G Smith

Sandra Rainbow

SP Halloran

SR Cole

Stephen Halloran

Stephen Morris

Stephen W Duffy

Steve Smith

Sue Moss

Wendy Atkin

British Journal of Cancer

PubMed

Background: There is a socioeconomic gradient in the uptake of screening in the English NHS Bowel Cancer Screening Programme (BCSP), potentially leading to inequalities in outcomes. We tested whether endorsement of bowel cancer screening by an individual’s general practice (GP endorsement; GPE) reduced this gradient.  Methods: A cluster-randomised controlled trial. Over 20 days, individuals eligible for screening in England from 6480 participating general practices were randomly allocated to receive a GP-endorsed or the standard invitation letter. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation.  Results: We enrolled 265 434 individuals. Uptake was 58.2% in the intervention arm and 57.5% in the control arm. After adjusting for age, sex, hub and screening episode, GPE increased the overall odds of uptake (OR=1.07, 95% CI 1.04–1.10), but did not affect its socioeconomic gradient. We estimated that implementing GPE could result in up to 165 more people with high or intermediate risk colorectal adenomas and 61 cancers detected, and a small one-off cost to modify the standard invitation (£78 000).  Conclusions: Although GPE did not improve its socioeconomic gradient, it offers a low-cost approach to enhancing overall screening uptake within the NHS BCSP

Raine, Rosalind

Duffy, Stephen W

Wardle, Jane

Solmi, Francesca

Morris, Stephen

Howe, Rosemary

Kralj-Hans, Ines

Snowball, Julia

Counsell, Nicholas

Moss, Sue

Hackshaw, Allan

von Wagner, Christian

Vart, Gemma

McGregor, Lesley M

Smith, Samuel G

Stirling Online Research Repository (RIOXX)

Impact of general practice endorsement on the social gradient in uptake in bowel cancer screening

BACKGROUND: There is a socioeconomic gradient in the uptake of screening in the English NHS Bowel Cancer Screening Programme (BCSP), potentially leading to inequalities in outcomes. We tested whether endorsement of bowel cancer screening by an individual's general practice (GP endorsement; GPE) reduced this gradient. METHODS: A cluster-randomised controlled trial. Over 20 days, individuals eligible for screening in England from 6480 participating general practices were randomly allocated to receive a GP-endorsed or the standard invitation letter. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. RESULTS: We enrolled 265 434 individuals. Uptake was 58.2% in the intervention arm and 57.5% in the control arm. After adjusting for age, sex, hub and screening episode, GPE increased the overall odds of uptake (OR=1.07, 95% CI 1.04-1.10), but did not affect its socioeconomic gradient. We estimated that implementing GPE could result in up to 165 more people with high or intermediate risk colorectal adenomas and 61 cancers detected, and a small one-off cost to modify the standard invitation (£78 000). CONCLUSIONS: Although GPE did not improve its socioeconomic gradient, it offers a low-cost approach to enhancing overall screening uptake within the NHS BCSP.British Journal of Cancer advance online publication 7 January 2016; doi:10.1038/bjc.2015.413 www.bjcancer.com

Raine, R

Duffy, SW

Wardle, J

Solmi, F

Morris, S

Howe, R

Kralj-Hans, I

Snowball, J

Counsell, N

Moss, S

Hackshaw, A

von Wagner, C

Vart, G

McGregor, LM

Smith, SG

Halloran, S

Handley, G

Logan, RF

Rainbow, S

Smith, S

Thomas, MC

Atkin, W

UCL Discovery

Background: There is a socioeconomic gradient in the uptake of screening in the English NHS Bowel Cancer Screening Programme (BCSP), potentially leading to inequalities in outcomes. We tested whether endorsement of bowel cancer screening by an individual’s general practice (GP endorsement; GPE) reduced this gradient.  Methods: A cluster-randomised controlled trial. Over 20 days, individuals eligible for screening in England from 6480 participating general practices were randomly allocated to receive a GP-endorsed or the standard invitation letter. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation.  Results: We enrolled 265 434 individuals. Uptake was 58.2% in the intervention arm and 57.5% in the control arm. After adjusting for age, sex, hub and screening episode, GPE increased the overall odds of uptake (OR=1.07, 95% CI 1.04–1.10), but did not affect its socioeconomic gradient. We estimated that implementing GPE could result in up to 165 more people with high or intermediate risk colorectal adenomas and 61 cancers detected, and a small one-off cost to modify the standard invitation (£78 000).  Conclusions: Although GPE did not improve its socioeconomic gradient, it offers a low-cost approach to enhancing overall screening uptake within the NHS BCSP.Additional co-authors: Stephen Halloran, Graham Handley, Richard F Logan, Sandra Rainbow, Steve Smith, Mary C Thomas, Wendy Atki

Stirling Online Research Repository

English

McGregor, L

Surrey Research Insight

Crossref

background:  There is a socioeconomic gradient in the uptake of screening in the English NHS Bowel Cancer Screening Programme (BCSP), potentially leading to inequalities in outcomes. We tested whether endorsement of bowel cancer screening by an individual’s general practice (GP endorsement; GPE) reduced this gradient.
methods:  A cluster-randomised controlled trial. Over 20 days, individuals eligible for screening in England from 6480 participating general practices were randomly allocated to receive a GP-endorsed or the standard invitation letter. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation.
results:  We enrolled 265 434 individuals. Uptake was 58.2% in the intervention arm and 57.5% in the control arm. After adjusting for age, sex, hub and screening episode, GPE increased the overall odds of uptake (OR=1.07, 95% CI 1.04–1.10), but did not affect its socioeconomic gradient. We estimated that implementing GPE could result in up to 165 more people with high or intermediate risk colorectal adenomas and 61 cancers detected, and a small one-off cost to modify the standard invitation (£78 000).
conclusions:  Although GPE did not improve its socioeconomic gradient, it offers a low-cost approach to enhancing overall screening uptake within the NHS BCSP

Spiral - Imperial College Digital Repository

Queen Mary Research Online

http://creativecommons.org/licenses/by-nc-sa/4.0/

Impact of general practice endorsement on the social gradient in uptake in bowel cancer screening

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