Implementation of long-term non-participant reminders for flexible sigmoidoscopy screening

Area of Science:

• Gastroenterology
• Public Health
• Preventive Medicine

Background:

• Screening program effectiveness relies heavily on participant uptake.
• Non-participant reminders have shown potential to improve screening attendance in prior studies.
• The English Flexible Sigmoidoscopy (FS) Screening Programme offers a one-time screening to adults aged 55-59.

Purpose of the Study:

• To evaluate the impact of implementing non-participant reminders on screening uptake within the English FS Programme.
• To assess changes in adenoma detection rate (ADR) following the implementation of reminders.

Main Methods:

• Assessed screening status of 26,339 individuals invited for FS screening.
• Sent reminders to 15,387 non-attendees 1-2 years post-invitation.
• Used descriptive statistics and Pearson's Chi-Square to analyze uptake and ADR.

Main Results:

• 8.0% of those sent a reminder booked and attended screening, increasing overall uptake by 4.1% (from 41.6% to 45.7%).
• The adenoma detection rate (ADR) was significantly higher in self-referrers (13.3%) compared to initial attendees (9.5%).
• Reminder delivery was successful in 88.6% of eligible individuals.

Conclusions:

• Non-participant reminders moderately increased flexible sigmoidoscopy screening uptake.
• The higher ADR in the self-referred group suggests improved detection of adenomas.
• Implementing reminders may help counteract declines in screening uptake, potentially exacerbated by factors like COVID-19.