A recent study investigated predictors of repeat participation in the NHS Bowel Cancer Screening Programme (BCSP). Most types of population-based cancer screening require repeat participation to be effective.
Guaiac fecal occult blood test (gFOBt) was performed as a biennial colorectal cancer-screening test in the BCSP in England for the age group of 60-74 years.
A total of 62,081 participants were aged 60-64 years at the time of the first invitation were recruited for the study. The main outcome was repeat participation at their second or third invitation.
Behavioural measures derived from screening records included late return of the gFOBt kit, compliance with follow-up investigations and previous screening participation.
Other potential predictors of repeat participation included results of individual test kit analysis (normal, weak positive, strong positive, spoilt) and the definitive result of the gFOBt screening episode (normal or abnormal). Age, sex and socioeconomic deprivation were also recorded.
Overall repeat uptake was 82% in the second and third invitations on an average. Late return of the test kit was consistently associated with lower uptake.
A definitive abnormal gFOBt result in the previous screening episode was a negative predictor of repeat uptake.
Weak positive and spoilt test kits were associated with lower repeat uptake, but were not consistently independent predictors in all invitation rounds or subgroups.
Among those with a definitive abnormal gFOBt result, noncompliance with follow-up in a previous screening episode was also associated with lower repeat uptake.
Behavioural markers and test results from previous screening episodes have been implicated in subsequent gFOBt uptake.