Increasing uptake of FIT colorectal screening: protocol for the TEMPO randomised controlled trial testing a suggested deadline and a planning tool.

Introduction: Screening can reduce deaths from colorectal cancer (CRC). Despite high levels of public enthusiasm, participation rates in population CRC screening programmes internationally remain persistently below target levels. Simple behavioural interventions such as completion goals and planning tools may support participation among those inclined to be screened but who fail to act on their intentions.

Development of an evidence-based brief 'talking' intervention for non-responders to bowel screening for use in primary care: stakeholder interviews.

Background: Bowel cancer is the third most common cause of cancer death worldwide. Bowel screening has been shown to reduce mortality and primary care interventions have been successful in increasing uptake of screening. Using evidence-based theory to inform the development of such interventions has been shown to increase their effectiveness.

Screening for colorectal cancer in defunctioned colons.

Objectives: Population-based colorectal (bowel) cancer screening using faecal occult blood tests leads to a reduction in cause-specific mortality. However, in people where the colon is defunctioned, the use of standard faecal occult blood test is not appropriate. The aim of this study was to examine the current trends of clinical practice for colorectal cancer screening in people with defunctioned colons.

Participation in bowel screening among men attending abdominal aortic aneurysm screening.

Background: Uptake of population-based screening for colorectal cancer in Scotland is around 55 per cent. Abdominal aortic aneurysm (AAA) screening has recently been introduced for men aged 65 years and the reported uptake is 78 per cent. The aim was to determine the impact of a brief intervention on bowel screening in men who attended AAA screening, but previously failed to complete bowel screening.

Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland.

Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.

Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted.

Anticipated regret to increase uptake of colorectal cancer screening (ARTICS): A randomised controlled trial.

Screening is important for early detection of colorectal cancer. Our aim was to determine whether a simple anticipated regret (AR) intervention could increase uptake of colorectal cancer screening. A randomised controlled trial of a simple, questionnaire-based AR intervention, delivered alongside existing pre-notification letters, was conducted.

Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity.

Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.

Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.

Deprivation and faecal haemoglobin: implications for bowel cancer screening.

Objective: To investigate the relationship between deprivation and faecal haemoglobin concentration (f-Hb).

Setting: Scottish Bowel Screening Programme.

Methods: A total of 66725 men and women, aged 50 to 74, were invited to provide a single sample for a faecal immunochemical test.

Patterns of uptake in a biennial faecal occult blood test screening programme for colorectal cancer.

Aim: The patterns of response in faecal occult blood test (FOBT) screening were studied.

Method: A total of 251,578 people invited three times for faecal occult blood testing were categorized according to how they responded to the invitations, as follows: YNN, NYN, NNY, NYY, YNY, YYN, YYY or NNN (Y = response; N = no response).

Results: Overall, 163,038 (64.

Faecal haemoglobin concentration is related to severity of colorectal neoplasia.

Aims: Guaiac faecal occult blood tests are being replaced by faecal immunochemical tests (FIT). We investigated whether faecal haemoglobin concentration (f-Hb) was related to stage in progression of colorectal neoplasia, studying cancer and adenoma characteristics in an evaluation of quantitative FIT as a first-line screening test.

Methods: We invited 66 225 individuals aged 50-74 years to provide one sample of faeces.

Low faecal haemoglobin concentration potentially rules out significant colorectal disease.

Aim: The study aimed to determine whether faecal haemoglobin (Hb) concentration can assist in deciding who with lower abdominal symptoms will benefit from endoscopy.

Method: Faecal Hb concentrations were measured on single samples from 280 patients referred for lower gastrointestinal tract endoscopy from primary care in NHS Tayside who completed a faecal immunochemical test (FIT) for Hb and underwent subsequent endoscopy.

Results: Among 739 invited patients, FIT and endoscopy were completed by 280 (median age 63 (18-84) years; 59.

Faecal haemoglobin concentrations by gender and age: implications for population-based screening for colorectal cancer.

Background: Faecal immunochemical tests (FIT) are becoming widely used in colorectal cancer screening. Estimation of faecal haemoglobin concentration in a large group prompted an observational study on gender and age.

Methods: A single estimate of faecal haemoglobin concentration was made using quantitative automated immunoturbidimetry.

Pre-notification increases uptake of colorectal cancer screening in all demographic groups: a randomized controlled trial.

Objectives: To assess whether pre-notification is effective in increasing uptake of colorectal cancer screening for all demographic groups.

Setting: Scottish national colorectal cancer screening programme.

Methods: Males and females aged 50-74 years received a faecal occult blood test by post to complete at home.

Experience with a wipe guaiac-based faecal occult blood test as an alternative test in a bowel screening programme.

The format of the traditional guaiac faecal occult blood test (gFOBT), particularly the collection technique, might cause difficulties for some. A multistage evaluation of alternative tests was performed. Firstly, four tests with different faecal collection approaches were assessed: a focus group recommended further investigation of a wipe gFOBT.

Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme.

Objectives: To assess the effect of gender, age and deprivation on key performance indicators in a colorectal cancer screening programme.

Setting: Between March 2000 and May 2006 a demonstration pilot of biennial guaiac faecal occult blood test (gFOBT) colorectal screening was carried out in North-East Scotland for all individuals aged 50-69 years.

Methods: The relevant populations were subdivided, by gender, into four age groups and into five deprivation categories according to the Scottish Index of Multiple Deprivation (SIMD), and key performance indicators analysed within these groups.

Automated immunochemical quantitation of haemoglobin in faeces collected on cards for screening for colorectal cancer.

Background: Simple card collection systems are becoming available for faecal immunochemical tests (FITs) as well as guaiac faecal occult blood tests (gFOBTs). FITs are now obtainable that allow quantitation of haemoglobin, so that the analytical detection limit can be set to give a positivity rate that is manageable in terms of the available colonoscopy. A combination of a card collection device and an automated FIT analytical system could be advantageous.

Faecal occult blood tests--eliminate, enhance or update?

Traditional guaiac-based faecal occult blood tests (FOBT) are commonly performed investigations in laboratories, wards, clinics and general practices. Although there is much evidence that use of FOBT in asymptomatic population screening programmes for colorectal (bowel) cancer does reduce mortality, there is little, if any, evidence of the value of FOBT in symptomatic individuals. In contrast, recent evidence-based guidelines are unequivocal that most of those presenting with symptoms should have bowel visualization and that the only laboratory test required is the full blood count.

Evaluation of a card collection-based faecal immunochemical test in screening for colorectal cancer using a two-tier reflex approach.

Background: The guaiac faecal occult blood test (gFOBT) has been proved as a screening investigation for colorectal cancer, but has disadvantages. Newer faecal immunochemical tests (FITs) have many advantages, but yield higher positivity rates and are expensive. A two-tier reflex follow-up of gFOBT-positive individuals with a FIT before colonoscopy has been advocated as an efficient and effective approach.