Testing the effectiveness of a general practice intervention to improve uptake of colorectal cancer screening: a randomised controlled trial

Aust N Z J Public Health. 2019 Oct;43(5):464-469. doi: 10.1111/1753-6405.12913. Epub 2019 Jul 3.

Abstract

Objective: Uptake of screening through the Australian National Bowel Cancer Screening Program remains low. General practice guidelines support the general practitioners' role to offer CRC screening. This study tests the effect that an intervention including point-of-care FOBT provision, printed screening advice and GP endorsement has on self-reported FOBT uptake.

Methods: A multisite, 1:1 parallel-arm, cluster-randomised controlled trial. Participants aged 50-74, at average risk of CRC and overdue for screening were recruited from four general practices in New South Wales, Australia, from September 2016 to May 2017. Self-report of FOBT up to eight weeks post baseline.

Results: A total of 336 participants consented to complete a baseline survey (64% consent rate), of which 123 were recruited into the trial (28 usual care days and 26 intervention days). Follow-up data was collected for 114 participants (65 usual care and 49 intervention). Those receiving the intervention had ten times greater odds of completing screening compared to usual care (39% vs. 6%; OR 10.24; 95%CI 2.9-36.6, p=0.0006).

Conclusions: A multicomponent intervention delivered in general practice significantly increased self-reported FOBT uptake in those at average risk of CRC. Implications for public health: General practice interventions could serve as an important adjunct to the Australian National Bowel Cancer Screening Program to boost plateauing screening rates.

Keywords: colorectal cancer; early detection of cancer; faecal occult blood test; general practice; randomised controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Australia / epidemiology
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Delivery of Health Care
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • General Practice
  • General Practitioners / statistics & numerical data*
  • Humans
  • Male
  • Mass Screening* / organization & administration
  • Middle Aged
  • New South Wales
  • Occult Blood*
  • Outcome and Process Assessment, Health Care
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Program Evaluation
  • Surveys and Questionnaires