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GPs encouraged to send personal reminders for bowel cancer screening

GPs can help boost the uptake of bowel cancer screening in the over-60s by sending them a personal reminder letter, a study has shown.

Under the NHS Bowel Cancer Screening Programme, all 60-74-year-olds are invited to be screened for the disease every two years, using a home testing kit, but in 2014/15 the uptake was only 58%.

A trial involving 25 GP practices in Wessex with low uptake of screening (under 55%) saw over 3,000 reminder letters sent on GP practice-headed paper and with the signature of the patient’s GP. The letter was sent to patients who had been invited for screening and sent a 28-day reminder letter by the NHS, but had not returned their test kit.

Researchers found that among the patients who received the letter signed by their GP, uptake was three percentage points higher than in a control group of patients who did not receive the letter.

They said that extrapolated across England, that could amount to an extra 123,000 people participating in screening every year, detecting an extra 453 peole with polyps which can go on to form cancer and 150 cases bowel cancer, each year.

The paper, published in the British Journal of Cancer, concluded: ‘The GP-endorsed reminder was associated with significantly increased uptake among subjects not responding to the standard reminder letter.’

They noted that sending the letters ‘required continuous engagement from GP practices and created additional work’ and that therefore ‘whether this is sustainable across the country is questionable when considering the pressures that GPs face’.

But Fareham GP Dr Richard Roope, Cancer Research UK clinical champion and one of the study authors, said that ‘automated’ but ‘personalised’ GP reminders ‘doesn’t require a lot of work for receptionists’.

Arguing that ‘anything that works to increase bowel screening participation should be considered’, he said: ‘All they need to do is delete names from the automated list when the GP thinks it’s inappropriate to send a letter – if, for example, a patient is already being treated or receiving end of life care.’

A similar study published last year showed that GP practice-headed letters could lead to 40,000 extra patients participating in bowel cancer screening.


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