title: Uptake of Bowel Scope (Flexible Sigmoidoscopy) Screening in the English National Programme: the first 14 months.
abstract: To examine uptake in the first six pilot centres of the English Bowel Scope Screening (BSS) programme, which began in early 2013 and invites adults aged 55 for a one off Flexible Sigmoidoscopy.
  
  
  
  Between March 2013 and May 2014 the six pilot centres sent 21,187 invitations. Using multivariate logistic regression analysis, we examined variation in uptake by gender, socioeconomic deprivation (using the Index of Multiple Deprivation), area-based ethnic diversity (proportion of non-white residents), screening centre, and appointment time (routine: daytime vs out-of-hours: evening/weekend).
  
  
  
  Uptake was 43.1%. Men were more likely to attend than women (45% vs 42%; OR 1.136, 95% CI 1.076, 1.199, p < 0.001). Combining data across centres, there was a socioeconomic gradient in uptake, ranging from 33% in the most deprived to 53% in the least deprived quintile. Areas with the highest level of ethnic diversity also had lower uptake (39%) than other areas (41-47%) (all p < 0.02), but there was no gradient. Individuals offered a routine appointment were less likely to attend than those offered an out-of-hours appointment (42% vs. 44%; OR 0.931, 95% CI 0.882, 0.983, p = 0.01). Multivariate analyses confirmed independent effects of deprivation, gender, and centre, but not of ethnic diversity or appointment time.
  
  
  
  Early indications of uptake are encouraging. Future efforts should focus on increasing public awareness of the programme and reducing socioeconomic inequalities.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: McGregor
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London.
authors.forename: Bernardette
authors.initials: B
authors.lastname: Bonello
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kerrison
authors.affiliation: NHS Cancer Screening Programmes, Sheffield.
authors.forename: Claire
authors.initials: C
authors.lastname: Nickerson
authors.affiliation: Department of Statistical Science, University College London.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baio
authors.affiliation: Patient Representative.
authors.forename: Lindy
authors.initials: L
authors.lastname: Berkman
authors.affiliation: South Tyneside NHS Foundation Trust, South Tyneside School of Medicine, Health and Pharmacy, University of Durham, County Durham.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: Rees
authors.affiliation: Deparment of Surgery and Cancer, Imperial College London, St Mary's Campus, London.
authors.forename: Wendy
authors.initials: W
authors.lastname: Atkin
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London.
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London c.wagner@ucl.ac.uk.
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004739:England; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012737:Sex Factors; D012812:Sigmoidoscopy / Q000379:methods*; D012959:Socioeconomic Factors; D013222:State Medicine
keywords: Appointments; Bowel Scope; Colorectal Cancer; Flexible Sigmoidoscopy; Screening; Socioeconomic Deprivation; Uptake