Additional mailing phase for FIT after a medical offer phase: The best way to improve compliance with colorectal cancer screening in France.

Background: Compliance with colorectal cancer screening is critical to its effectiveness. The organisation of the mass screening programme in France has recently been modified with no evaluation of the consequences.

Aims: To evaluate the impact of the way the screening test is delivered on compliance.

Patients And Methods: During the first six months of the screening campaign (Ille-Vilaine, Brittany), general practitioners were asked to propose a faecal immunochemical test (FIT), OC-Sensor, to individuals at average risk for colorectal cancer (n=152,097). A subset of non-participants in the medical phase (n=13,071) was randomly chosen to receive a reminder that included the screening test or a simple postal reminder without the screening test.

Results: Compliance was 31% if the screening test was proposed during a medical consultation. In non-participants during the medical phase, it was 45% in those receiving both a reminder and the screening test and 28% amongst those receiving a simple reminder. An estimated overall participation rate of 54% can be expected if non-participants in the medical phase are sent a reminder together with the screening test.

Conclusion: In France, a compliance rate above the minimum uptake rate of 45% recommended by European Union experts can be achieved if the FIT is mailed to non-participants after the medical free-offer phase.