title: A comparison of different strategies used to invite subjects with a positive faecal occult blood test to a colonoscopy assessment. A randomised controlled trial in population-based screening programmes.
abstract: OBJECTIVE
  The purpose of this parallel randomised controlled trial was to compare compliance with different modalities used to invite patients with a positive immunochemical faecal occult blood test (FIT+) for a total colonoscopy (TC).
  
  
  METHODS
  FIT+ patients from nine Italian colorectal cancer screening programmes were randomised to be invited for a TC initially by mail or by phone and, for non-compliers, to be recalled by mail, for counselling with a general practitioner, or to meet with a specialist screening practitioner (nurse or healthcare assistant).
  
  
  RESULTS
  In all, 3777 patients were randomised to different invitation strategies. Compliance with an initial invitation by mail and by phone was similar (86.0% vs. 84.0%, relative risk - RR: 1.02; 95%CI 0.97-1.08). Among non-responders to the initial invitation, compliance with a recall by appointment with a specialist practitioner was 50.4%, significantly higher than with a mail recall (38.1%; RR:1.33; 95%CI 1.01-1.76) or with a face-to-face counselling with the GP (30.8%; RR:1.45;95%CI 1.14-1.87).
  
  
  CONCLUSIONS
  Compliance with an initial invitation for a TC by mail and by phone was similar. A personal meeting with a specialist screening practitioner was associated with the highest compliance among non-compliers with initial invitations, while the involvement of GPs in this particular activity seemed less effective.
authors.affiliation: Registro Tumori del Veneto, Passaggio Gaudenzio 1, Padova, Italy. Electronic address: manuel.zorzi@ioveneto.it.
authors.forename: Manuel
authors.initials: M
authors.lastname: Zorzi
authors.affiliation: Servizio Interaziendale Epidemiologia, Azienda Sanitaria Locale di Reggio Emilia, via Amendola 2, Reggio Emilia, Italy. Electronic address: Paolo.GiorgiRossi@ausl.re.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.affiliation: Registro Tumori del Veneto, Passaggio Gaudenzio 1, Padova, Italy. Electronic address: crr.screening@ioveneto.it.
authors.forename: Carla
authors.initials: C
authors.lastname: Cogo
authors.affiliation: Unità Operativa di Prevenzione Oncologica, Ospedale Civile G.B. Morgagni L. Pierantoni, AUSL di Forlì, via Forlanini 34, Forlì, Italy. Electronic address: f.falcini@ausl.fo.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.affiliation: S.C. Epidemiologia e Screening, Azienda Sanitaria Locale 2 di Lucca, via per Sant'Alessio - Monte San Quirico, Lucca, Italy. Electronic address: d.giorgi@usl2.toscana.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Giorgi
authors.affiliation: Screening Unit Cancer Prevention and Research Institute ISPO, via Cosimo il Vecchio 2, Firenze, Italy. Electronic address: g.grazzini@ispo.toscana.it.
authors.forename: Grazia
authors.initials: G
authors.lastname: Grazzini
authors.affiliation: Laboratorio Unico di Screening, Azienda Sanitaria Locale 2 di Perugia, via XIV settembre 75, Perugia, Italy. Electronic address: lmariotti@ausl2.umbria.it.
authors.forename: Loretta
authors.initials: L
authors.lastname: Mariotti
authors.affiliation: Unità Operativa di Gastroenterologia, Azienda Ospedaliero-Universitaria S. Anna, Cona-Ferrara, via Moro 8, Cona,FE, Italy. Electronic address: mtv@unife.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Matarese
authors.affiliation: Dipartimento di Prevenzione, Azienda Sanitaria Locale 1 di Belluno, via S. Andrea 8, Belluno, Italy. Electronic address: fabio.soppelsa@ulss.belluno.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Soppelsa
authors.affiliation: Centro per la Prevenzione Oncologica (CPO), via San Francesco da Paola 31, Torino, Italy. Electronic address: carlo.senore@cpo.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Senore
authors.affiliation: Dipartimento di Prevenzione, Azienda Sanitaria Locale 17 di Este Monselice, via Francesconi 2, Este,PD, Italy. Electronic address: antonio.ferro@ulss17.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferro
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003376:Counseling; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D009819:Office Visits; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011177:Postal Service; D013038:Specialization; D013689:Telephone
keywords: Colorectal cancer screening; Compliance with colonoscopy; Faecal occult blood test