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Using primary care-based paper and telephone interventions to increase uptake of bowel scope screening in Yorkshire: a protocol of a randomised controlled trial
  1. Lesley M McGregor1,
  2. Robert S Kerrison1,
  3. Trish Green2,
  4. Una Macleod2,
  5. Mark Hughes3,
  6. Monica Gibbins4,
  7. Stephen Morris5,
  8. Colin Rees6,
  9. Christian von Wagner1
  1. 1 Research Department of Behavioural Science and Health, University College London, London, UK
  2. 2 Hull York Medical School, University of Hull, Hull, UK
  3. 3 Hull and East Yorkshire Bowel Cancer Screening Centre, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
  4. 4 Patient Representative, Leicester, UK
  5. 5 Department of Applied Health Research, University College London, London, UK
  6. 6 South Tyneside NHS Foundation Trust, South Tyneside District Hospital, South Shields, UK
  1. Correspondence to Dr Lesley M McGregor; l.mcgregor{at}


Introduction Evidence suggests bowel scope screening (BSS) can significantly reduce an individual’s risk of developing colorectal cancer (CRC). BSS for 55 year olds was therefore introduced to the English Bowel Cancer Screening Programme (BCSP) in 2013. However, the benefits are only gained from test completion and uptake is low (43%). Primary care involvement has consistently shown benefits to cancer screening uptake and so this study aims to build on this knowledge and evaluate general practitioner (GP) practice led interventions designed to increase BSS attendance.

Methods and analysis A three-arm randomised controlled trial will be conducted to evaluate three interventions: one intervention for prospective BSS invitees (primer letter with locally tailored leaflet sent by an individual’s GP practice) and two interventions for those who do not attend their BSS appointment (a self-referral letter sent by an individual’s GP practice and a patient navigation call made on behalf of an individual’s GP practice). The trial will be set in Yorkshire. Individuals soon to receive their invitation to attend BSS at one of the Hull and East Yorkshire Bowel Cancer Screening centre sites, will be randomly assigned to one of three groups: control (usual care; no input from GP practice), Intervention group A (primer letter/leaflet and a self-referral letter), Intervention group B (primer letter/leaflet and a patient navigation call). Attendance data will be obtained from the BCSP database (via National Health Service (NHS) Digital) 3 months after the last intervention. Regression analysis will compare uptake, and additional clinical outcomes, across the three groups. The analysis will be multivariate and adjust for several covariates including gender and area-level deprivation.

Ethics and dissemination NHS ethical approval has been obtained from London-Harrow Research Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.

Trial registration number ISRCTN16252122; Pre-results.

  • flexible sigmoidoscopy
  • cancer screening
  • intervention
  • general practitioners
  • patient navigation

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  • Contributors LMM and CvW are the principal investigators on this funded study and devised the research aims, objectives and methodology. LMM manages the approvals and recruitment for the trial, supervises RSK and drafted the initial manuscript, managed further iterations and submitted for publication. RSK is a coinvestigator on this study, contributed to the study design and has led the development of the intervention materials. UM is a coinvestigator on this study and contributed to the study design. TG is a coinvestigator on this study, contributed to the study design and has supported the development of study materials and General Practice recruitment. MH is a coinvestigator on this study, provides advice and guidance from the perspective of the local screening centre, and oversees the centre’s role in this study. SM is a coinvestigator on this study and devised the cost analysis plans for the interventions included in this trial. CR is a coinvestigator on this study and contributed to the study design. MG is a coinvestigator on this study and offers advice and guidance on study design and documentation from the perspective of a patient and member of the public.

  • Funding This work is funded by Yorkshire Cancer Research (registered charity 516898; Award reference number UCL407).

  • Disclaimer Neither Yorkshire Cancer Research nor the study sponsors have had any input to the design of this study.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval London-Harrow Research Ethics Committee.

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

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