title: Uptake of population-based flexible sigmoidoscopy screening for colorectal cancer: a nurse-led feasibility study.
abstract: OBJECTIVE
  To assess uptake of once-only flexible sigmoidoscopy (FS) in a community sample to determine whether FS would be viable as a method of population-based screening for colorectal cancer.
  
  
  METHODS
  All adults aged 60-64 years registered at three General Practices in North West London, UK (510 men and women) were sent a letter of invitation to attend FS screening carried out by an experienced nurse, followed by a reminder if they did not make contact to confirm or decline the invitation. The primary outcome was attendance at the endoscopy unit for a FS test.
  
  
  RESULTS
  Of the 510 people invited to attend, 280 (55%) underwent FS. Among non-attenders, 91 (18%) were ineligible for screening or did not receive the invitation, 19 (4%) accepted the offer of screening but were unable to attend during the study period, 52 (10%) declined the offer, 41 (8%) did not respond to the invitation, and 27 (5%) accepted the offer of screening but did not attend. Attendance among those eligible to be screened, who had received the invitation, was 67%. People from more socioeconomically deprived neighbourhoods were less likely to attend (odds ratio [OR] = 0.90; confidence interval [CI] = 0.84-0.96; P = 0.003). Women were more likely to attend than men (OR = 1.44; CI = 1.01-2.05; P = 0.041).
  
  
  CONCLUSIONS
  Attendance rates in this pilot for nurse-led, population-based FS screening were higher than those reported in other FS studies, and comparable with adherence to fecal occult blood testing (FOBT) in the UK FOBT pilot. Having a female nurse endoscopist may have been responsible for increasing female uptake rates but this warrants confirmation in a larger study.
authors.affiliation: Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Brotherstone
authors.forename: Maggie
authors.initials: M
authors.lastname: Vance
authors.forename: Robert
authors.initials: R
authors.lastname: Edwards
authors.forename: Anne
authors.initials: A
authors.lastname: Miles
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Robb
authors.forename: Ruth E C
authors.initials: RE
authors.lastname: Evans
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Wendy
authors.initials: W
authors.lastname: Atkin
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D024802:Nurse's Role; D009726:Nurses; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012812:Sigmoidoscopy / Q000379:methods*; D006113:United Kingdom