A new study has found that a simple change in the invitation letter for colorectal cancer screening in Scotland significantly improved test return rates. Researchers say adding a suggested deadline for returning the fecal immunochemical test (FIT) led to a measurable increase in participation, providing a cost-effective way to boost early detection efforts.
Study Finds Deadlines Encourage Timely Test Returns
The trial, known as TEMPO, involved 40,000 adults aged 50–74 who were eligible for colorectal cancer screening. Participants were randomly assigned to receive one of eight different invitation formats, with varying combinations of suggested deadlines and a planning tool to help individuals complete the test.
- The control group received the standard invitation with no deadline or planning tool.
- Four groups received invitations with deadlines of 1, 2, or 4 weeks.
- Three groups received both a deadline and a planning tool.
Researchers then analyzed how many people returned their FIT samples within three months of receiving their invitation.
2-Week Deadline Produced the Best Results
The results showed that a 2-week deadline led to the highest return rate, at 68.0%, compared to 66.0% in the control group. While a small increase, the researchers noted that even minor improvements in screening participation could lead to earlier cancer detection and better health outcomes.
Interestingly, the planning tool—designed to help people organize their test-taking process—did not improve return rates. In fact, when used without a deadline, it slightly reduced participation, with a return rate of 63.2%.
Statistical Breakdown of Findings
| Group | 3-Month FIT Return Rate |
|---|---|
| Standard Invitation (Control) | 66.0% |
| 2-Week Deadline | 68.0% |
| 1-Week Deadline | 67.5% |
| 4-Week Deadline | 66.8% |
| Planning Tool (No Deadline) | 63.2% |
Statistical analysis confirmed that providing a deadline significantly increased the odds of returning the FIT sample (adjusted odds ratio: 1.13). The planning tool, however, showed no significant impact and, in some cases, had a negative effect.
Cost-Effective and Easy to Implement
Dr. Kathryn Robb, lead researcher from the University of Glasgow, emphasized that adding a single sentence to the screening invitation—suggesting a deadline for returning the test—proved to be a highly cost-effective intervention. The change not only encouraged quicker returns but also reduced the need for reminder letters, saving additional resources.
Scotland has been working to improve colorectal cancer screening participation, as early detection significantly increases survival rates. This study suggests that minor tweaks to communication strategies could make a meaningful difference in public health outcomes.
The study, published in The Lancet, was funded by the Scottish Government and Cancer Research UK
