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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-02

AUTHORS

Rosalind Raine, Stephen W Duffy, Jane Wardle, Francesca Solmi, Stephen Morris, Rosemary Howe, Ines Kralj-Hans, Julia Snowball, Nicholas Counsell, Sue Moss, Allan Hackshaw, Christian von Wagner, Gemma Vart, Lesley M McGregor, Samuel G Smith, Stephen Halloran, Graham Handley, Richard F Logan, Sandra Rainbow, Steve Smith, Mary C Thomas, Wendy Atkin

ABSTRACT

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. More... »

PAGES

321

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/bjc.2015.413

DOI

http://dx.doi.org/10.1038/bjc.2015.413

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1031962625

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26742011


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