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Updated: Mar 16, 2026

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Theory-based modifications of an advanced notification letter improves screening for bowel cancer in men: A
Ian T Zajac1, Amy C Duncan2, Ingrid Flight3
1CSIRO Health & Biosecurity, South Australia, Australia.
Rationale:
Male participation in screening for bowel cancer is sub-optimal. Theory-based interventions provide a means of improving screening uptake.
Objective:
To test the efficacy of modifying consumer invitation material in line with continuum and stage theories of health behaviour on screening participation.
Methods:
N = 9216 Australian men aged 50-74 years were randomised to one of four trial arms in a 2 × 2 factorial design randomised controlled trial. Participants received either standard invitation material (control group), or combinations of modified advance-notification and invitation letters. A subsample completed baseline and endpoint behavioural surveys.
Results:
Participants who received the modified advance notification letter were 12% more likely to screen than those who received the standard version (RR = 1.12, χ(2)(1) = 10.38, p = 0.001). The modified invitation letter did not impact screening uptake (RR = 0.97, χ(2)(1) = 0.63, p = 0.424). No significant changes in psychological variables due to the intervention were observed.
Conclusion:
Modifications to advance notification letters in line with health behaviour theories significantly improves screening uptake in men.
Trial Registration:
Australian New Zealand Clinical Trials Registry: ACTRN12612001122842 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362688.
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