title: Use of research questionnaires in the NHS Bowel Cancer Screening Programme in England: impact on screening uptake.
abstract: BACKGROUND
  The NHS Bowel Cancer Screening Programme in England offers biennial screening to those aged 60-74 using a faecal occult blood test (FOBt) sent by post. Data from this national clinical programme can also be used for research. Awareness of the impact of such studies on screening participation is important.
  
  
  OBJECTIVE
  To investigate the effect on screening uptake of adding a research questionnaire to the postal screening invitation.
  
  
  METHODS
  People invited for screening in 2008-10 in two areas of England were randomized to receive or not to receive an additional research study questionnaire, consent form and study information, either with their test kit or 2-3 days later. Uptake of screening was examined in relation to study mailings.
  
  
  RESULTS
  Among 11,579 people invited for screening by the Midlands and North West Bowel Cancer Screening Hub, screening uptake was significantly lower in those who received study documents with their FOBt kit than in those who did not (48.6% vs 53.5% respectively: p < 0.001). The reduction in uptake was similar in men and women, and was greater in people living in more deprived areas. Among a further 36,195 people invited for screening by the Midlands and North West and Southern Hubs, sending study documents by separate mailing 2-3 days after the FOBt kit did not affect screening uptake (uptake with and without additional study mailing: Midlands and North West, 56.7% and 56.2% respectively, p = 0.6; Southern, 52.0% and 51.4% respectively, p = 0.5).
  
  
  CONCLUSIONS
  Researchers planning studies that include contact with potential participants within the NHS Bowel Cancer and similar screening programmes should be aware of the potential impact on uptake.
authors.affiliation: Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford OX3 7LF.
authors.forename: Joanna
authors.initials: J
authors.lastname: Watson
authors.forename: Keith
authors.initials: K
authors.lastname: Shaw
authors.forename: Maria
authors.initials: M
authors.lastname: Macgregor
authors.forename: Steve
authors.initials: S
authors.lastname: Smith
authors.forename: Stephen
authors.initials: S
authors.lastname: Halloran
authors.forename: Julietta
authors.initials: J
authors.lastname: Patnick
authors.forename: Valerie
authors.initials: V
authors.lastname: Beral
authors.forename: Jane
authors.initials: J
authors.lastname: Green
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: cancer screening; colorectal neoplasms; questionnaires; utilization