Cancer screening programmes could increase attendance by inviting people for screening close to birthdays or other annual milestones such as Christmas and the New Year, finds a study in the Christmas issue published on bmj.com today.
Colorectal cancer (bowel cancer) is the third most common cancer in the UK and the second leading cause of cancer deaths in Europe and the US. But despite the promotion of screening programmes in many western countries, attendance is generally low. Previous studies have identified barriers to attendance including anxiety and lack of knowledge about the test's risks and benefits, but the influence of age as a motivating factor, and the timing of invitations on screening attendance has never been tested.
Professor Geir Hoff and Michael Bretthauer from The Cancer Registry of Norway, examined whether tailoring the timing of colorectal cancer screening invitations to annual milestones such as birthdays, Christmas and the New Year, can improve attendance.
They randomly recruited 20,780 men and women aged 50-64 years from the population registry in Norway, and randomly assigned a screening appointment to them. The attendance rates for each week and month of assigned appointments were compared to participants' week/month of birthday. The overall attendance was 12,960 out of 20,003 (64.7%).
The researchers found that attendance rates were significantly higher in December compared to the rest of the year (72.3% versus 64.2%), and for individuals receiving their letter of invitation in the week of their birthday or assigned to screening 1-2 weeks after their birthday (67.9% versus 64.5%).
Age, being female, screening method, and geographical area of living were also independent predictors of attendance.
The authors suggest that invitation to screening close to the date of individuals' birthdays and to the month of December may improve attendance at screening programmes as well as its effectiveness for the prevention and early detection of disease.
Although the reasons for this are unknown, they may relate to annual reminders of ageing triggered by annual milestones such as birthdays and Christmas and the New Year, conclude the authors.