title: Screening for colorectal cancer by once only sigmoidoscopy: a feasibility study in Turin, Italy.
abstract: OBJECTIVE
  To assess the impact on compliance of three invitation methods, as well as the acceptability and efficacy of two bowel preparation regimens, for endoscopic screening in the general population.
  
  
  METHODS
  1170 subjects (men and women aged 55 to 59, in the rosters of a sample of general practitioners (GPs) in Turin), were randomly allocated to one of three invitation groups (A: personal letter, signed by GP, with a pre-fixed appointment; B: same as for A + letter supporting the study by a well known scientist; C: letter signed by the study coordinator, NS) and two preparation regimens (i: one enema, self administered at home two hours before the test; ii: two enemas, administered the night before and two hours before the test). A postal reminder was mailed to non-attenders. A sample of non-responders was contacted for a telephone interview by a trained nurse. Written consent was obtained from all subjects undergoing the test.
  
  
  RESULTS
  A total of 278 subjects attended for sigmoidoscopic screening. An invitation from the GP alone produced the highest response rate (compliance: A = 29.3%; B = 24.9%; C = 26.8%). A single enema was as effective as two enemas in achieving satisfactory preparation for the test: the proportion of subjects invited to repeat the test was 8.1% in the single enema group, and 9.6% in the group receiving two enemas.
  
  
  CONCLUSIONS
  Compliance with this screening procedure tends to be low. One enema, self administered two hours before sigmoidoscopy, can ensure a satisfactory bowel preparation.
authors.affiliation: Unita' di Epidemiologia dei Tumori, Dipartimento di Oncologia, Ospedale S Giovanni As, Torino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Senore
authors.forename: N
authors.initials: N
authors.lastname: Segnan
authors.forename: F P
authors.initials: FP
authors.lastname: Rossini
authors.forename: R
authors.initials: R
authors.lastname: Ferraris
authors.forename: M
authors.initials: M
authors.lastname: Cavallero
authors.forename: F
authors.initials: F
authors.lastname: Coppola
authors.forename: M
authors.initials: M
authors.lastname: Pennazio
authors.forename: W S
authors.initials: WS
authors.lastname: Atkin
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D004733:Enema / Q000379:methods; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance; D012812:Sigmoidoscopy; D016312:Treatment Refusal