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Impact of a mass media campaign on participation rates in a National Bowel Cancer Screening Program: a field experiment
  1. Sarah J Durkin1,2,
  2. Kate Broun3,
  3. Matthew J Spittal4,
  4. Melanie A Wakefield1,2
  1. 1 Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
  2. 2 Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
  4. 4 Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Professor Sarah J Durkin; sarah.durkin{at}


Objectives and design This field experiment aimed to compare bowel cancer screening participation rates prior to, during and after a mass media campaign promoting screening, and the extent to which a higher intensity campaign in one state led to higher screening rates compared with another state that received lower intensity campaign exposure.

Intervention An 8-week television-led mass media campaign was launched in selected regions of Australia in mid-2014 to promote Australia’s National Bowel Cancer Screening Program (NBCSP) that posts out immunochemical faecal occult blood test (iFOBT) kits to the homes of age-eligible people. The campaign used paid 30-second television advertising in the entire state of Queensland but not at all in Western Australia. Other supportive campaign elements had national exposure, including print, 4-minute television advertorials, digital and online advertising.

Outcome measures Monthly kit return and invite data from NBCSP (January 2012 to December 2014). Return rates were determined as completed kits returned for analysis out of the number of people invited to do the iFOBT test in the current and past 3 months in each state.

Results Analyses adjusted for seasonality and the influence of other national campaigns. The number of kits returned for analysis increased in Queensland (adjusted rate ratio 20%, 95% CI 1.06% to 1.35%, p<0.01) during the months of the campaign and up to 2 months after broadcast, but only showed a tendency to increase in Western Australia (adjusted rate ratio 11%, 95% CI 0.99% to 1.24%, p=0.087).

Conclusions The higher intensity 8-week television-led campaign in Queensland increased the rate of kits returned for analysis in Queensland, whereas there were marginal effects for the low intensity campaign elements in Western Australia. The low levels of participation in Australia’s NBCSP could be increased by national mass media campaigns, especially those led by higher intensity paid television advertising.

  • bowel cancer
  • screening
  • mass media
  • public education
  • faecal occult blood test
  • Australia

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  • Patient consent for publication None declared.

  • Contributors SJD and MAW contributed to the conception and design of the study. KB contributed to the acquisition of data and interpretation of the work. SJD, MJS and MAW contributed to data analysis and interpretation. SJD drafted and revised the paper, while MAW, KB and MJS revised the paper. All authors provided approval for the final version of the paper to be published.

  • Funding This study was funded by Cancer Council Victoria.

  • Competing interests SJD, KB and MAW are employed as researchers by Cancer Council Victoria, a state-based organisation affiliated with Cancer Council Australia which developed and ran the mass media campaign. MJS and all other authors have no other competing interests.

  • Ethics approval The AIHW follows Australian research ethics guidelines with data and considers whether the data request requires ethical approval, and they deemed that our data request did not require ethics approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The iFOBT invite and kit return data used in this study were secondary and originally obtained via a standard data request from the Australian Government Institute of Health and Welfare (AIHW) ( The data can be obtained directly from the Australian Government Institute of Health and Welfare (AIHW) on request (

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