Bowel cancer screening projects hub
Planning work in this area?
See the latest peer-reviewed evidence on increasing bowel screening uptake
We are sharing a selection of projects that aim to promote and increase bowel cancer screening uptake.
The case studies on this page have been sourced by the early diagnosis team at Cancer Research UK, or shared with us by project contacts. They have not been developed in partnership with Cancer Research UK or peer-reviewed, and their inclusion on our website does not mean we are endorsing them. They represent examples of good practice carried out locally across the UK, and are being shared with the aim that they will help to give people ideas, avoid wheels being reinvented, and save time.
If you would like more information about the hub, any of the case studies, or to send us feedback, email the Cancer Research UK early diagnosis team.
If you’re planning on doing work to improve bowel screening uptake see our summaries of the current peer-reviewed evidence in our evidence hub.
What interventions are covered?
Reviewing these case studies may be helpful for seeing how local areas are putting evidence into practice. You may find interventions that could be suitable in your own areas, or help other local teams to avoid challenges and pitfalls. Some of the case studies could form evidence of increasing bowel screening uptake in the future.
We’ve included projects that cover a range of interventions, including GP endorsement and community awareness projects. If this is a useful approach, then our plan is to continue to build this content over time.
GP Endorsement/Primary Care Involvement
A selection of projects undertaken in the primary care setting with the aim of improving bowel screening uptake.
Community Awareness Activities
A number of projects undertaken in the community, with the aim of improving awareness of bowel screening among various regions.
Improving Uptake Project
In Phase 1 of the Improving Bowel Cancer Screening Project, all GP practices in Pennine Lancashire were asked to contact 5+ patients who had not responded to their screening invitation. They chose to either telephone or send a letter, or discuss opportunistically face to face during a consultation. The practices were asked to review these patients 3-4 months later to see if they had subsequently attended, and review the result. GPs were also provided with an information pack and training.
- Practices were incentivised to take part. Any that demonstrated innovative methods of increasing patient participation were eligible to apply for additional payment
- Approximately 76 practices returned figures which were then collated and summarised
- 1,009 patients who had not initially participated in bowel screening were contacted
- 15.9% of patients subsequently requested replacement bowel screening kits and returned them to the screening hub
- Subsequent participation was more likely if there had been face to face discussion (35%) than telephone advice (20%), letter (11%) or unknown method of contact (8%)
Location: Pennine Lancashire, Blackburn with Darwen and East Lancashire CCGs
Contact: Dr Neil Smith, Cancer Clinical Lead, firstname.lastname@example.org
Automatic Email Request
In Phase 2 of the project in Lancashire, more links were established between the Bowel Cancer Screening Programme hub (for the North West & Midlands) and each GP Practice via the EMIS web record system. This enabled the direct electronic transfer of registered patients’ bowel screening results from the hub to each practice and also the option for practices to order a replacement test kit on behalf of a previous non-responder via email. Practices were similarly incentivised to take part in Phase 2 of the project.
- Preliminary data (as at February 2017) shows that 729 requests were made for replacement kits and 317 patients (44%) completed them, 7 abnormal results were recorded from 38 practices
- The project demonstrates that a large regional screening hub based in an acute hospital setting can work collaboratively with primary care professionals at a local level to achieve health improvement and a good outcome
- Phase 3 of the project will build on the work already achieved, sharing evidential learning with others and expanding as appropriate
Location: Pennine Lancashire – Blackburn with Darwen and East Lancashire CCGs
Contact: Dr Neil Smith, Cancer Clinical Lead, email@example.com
Call for a Kit Clinic
The ‘Call for a Kit’ intervention was set up in Lancashire to address previous non-responders. Those who have not completed the kit are invited to an appointment at their GP practice with the BCSP health promotion team. They are shown the kit and a DVD on how to complete it. Questions and anxieties are addressed, and if they agree to complete the test and require a replacement kit, the team phone the screening hub and order a kit on their behalf.
- 84% of people invited to the clinic actually attend in person; 91% of people attending the clinic have a kit ordered; 58% of people who attended subsequently completed the kit
- Gender specific clinics were also offered to patients, this worked well and helped subjects overcome issues around cultural dignity, discussing sensitive body parts and aided discussions on how to collect poo
- The clinic offered 5 different languages to engage with patients who actually attended
- Next steps include running the Call for a Kit clinics in next cohort of lowest uptake GP practices in each CCG
Contact: Shahida Hanif, BCSP Health Promotion Specialist, Shahida.Hanif@bfwhospitals.nhs.uk
Early Presentation Symptoms
A community-led engagement campaign (the Cancer Collaborative) was set up in North East Lincolnshire to work with healthcare professionals and to raise awareness of the signs and symptoms of cancer. When the bowel screening programme started, the activity was extended to include messages around screening. It draws upon the local experiences and knowledge of communities and practitioners to identify a wide range of solutions that will work locally.
- Marketing and community involvement materials were developed following audience testing
- Badges and stickers which could be worn by health professionals were developed and used as a prompt for conversation with patients
- Bowel screening uptake in North East Lincolnshire increased from 55.2% in 2008 to 59.9% in 2013
- Consistent ‘reminding’ of the key messages to the local target population has been seen to increase uptake in bowel screening
- In planning for the future, the team continue to monitor activity and work with primary care to focus on low uptake areas.
Location: North East Lancashire
Contact: Julie Grimmer, Collaborative Programme Manager, firstname.lastname@example.org
Till Receipt Awareness Campaign
Four 99p Stores in Merseyside were chosen to run a bowel screening awareness campaign based on their central locations, and due to their diverse population customer group. The campaign included awareness messages printed on the reverse side of till receipts, which were used at the main till banks. The till receipt included messaging such as: ‘Over 60? Do your bit – return your screening kit. Bowel screening saves lives.’
- Till receipt campaigns can be a low cost option to marketing awareness messages
- There were a number of limitations with the project, which included: difficulties with evaluation e.g. linking increases in participation directly with the campaign, other campaigns running at the same time
- It is recommended that healthcare partners pay close attention to contracting, ensuring all parties are clear on their commitments and expectations from the start.
Contact: Marie Coughlin, Screening and Immunisation Manager, email@example.com
Barbers Pilot Project
The barber’s project in Blackburn with Darwen was developed, facilitated and delivered by Sadiq Patel who is a BCSP Community Engagement Officer. Ten barbers were recruited to take part in the pilot within two low uptake, high ethnic minority areas. The barbers were supported to plan one week’s bowel cancer screening campaign within their salons and record data on the numbers engaged. They also recorded the key issues raised by local communities.
- The project was incentivised and barbers received an award once the project was completed
- Trained volunteers were involved in raising awareness at the barber shops during peak times, including holding weekly information stands in each shop
- Over 1,600 men were engaged within the salons by the ten barbers (1,099 of these men were below 60, and 671 were between 60-75)
- The project allowed for 1,770 bowel screening materials to beistributed
- Utilising barbers in engaging with specific communities was seen to be worthwhile.
Location: Lancashire, Blackburn and Darwen CCG
Contact: Sadiq Patel, BCSP Community Engagement Officer, Sadiq.Patel@bwdcvs.org.uk
How you can help
We would be interested to hear of any ideas or plans you may have for improving bowel screening uptake. If you would like to get involved, know of existing good practice examples, or relevant events or networks, please get in touch.
If you are aware of or are involved in projects that could demonstrate good practice, or may be useful for other reasons, please complete our case study submission form and email it to: firstname.lastname@example.org.