Text-message Reminders in Colorectal Cancer Screening (TRICCS): a randomised controlled trial

Abstract

Background:We investigated the effectiveness of a text-message reminder to improve uptake of the English Bowel Cancer Screening programme in London.Methods:We performed a randomised controlled trial across 141 general practices in London. Eight thousand two hundred sixty-nine screening-eligible adults (aged 60–74 years) were randomised in a 1 : 1 ratio to receive either a text-message reminder (n=4134) or no text-message reminder (n=4135) if they had not returned their faecal occult blood test kit within 8 weeks of initial invitation. The primary outcome was the proportion of adults returning a test kit at the end of an 18-week screening episode (intention-to-treat analysis). A subgroup analysis was conducted for individuals receiving an invitation for the first time.Results:Uptake was 39.9% in the control group and 40.5% in the intervention group. Uptake did not differ significantly between groups for the whole study population of older adults (adjusted odds ratio (OR) 1.03, 95% confidence interval (CI) 0.94–1.12; P=0.56) but did vary between the groups for first-time invitees (uptake was 34.9% in the control and 40.5% in the intervention; adjusted OR 1.29, 95% CI 1.04–1.58; P=0.02).Conclusions:Although text-message reminders did not significantly increase uptake of the overall population, the improvement among first-time invitees is encouraging.

Uptake of the English Bowel (Colorectal) Cancer Screening Programme: an update 5 years after the full roll-out

“…Regional differences in uptake, in particular the persistent and strong social gradient in London, are very striking considering the vast majority of initiatives and interventions taken place there; for example, a text message trial [12] , many community engagement initiatives with different ethnic groups [18] and national ASCEND trials [7] . Further research using spatial classification based on population density and location characteristics (urban vs. rural) may provide further insights into the better understanding of inequalities in London which are not usually a target of epidemiological research.…”

“…Uptake of the first-time invitations has emerged as a critical performance factor in light of evidence that people who completed their test kit at least once continued to do so in subsequent screening rounds [10] . Indeed, many recent interventions to promote uptake were only seen to be effective among this ‘first-time’ group as opposed to those receiving repeat invitations [11] , [12] .…”

The NHS Bowel Cancer Screening Program: current perspectives on strategies for improvement

“… 28 A recent trial of text message reminders found no significant main effect but a significant 5% increase in uptake among first-time invitees. 29 …”

Acceptability of text messages for safety netting patients with low-risk cancer symptoms: a qualitative study

“…Text message reminders have been shown to improve cancer screening uptake. 16 , 23 Also, there is encouraging evidence that text messages can be used in primary care to monitor acute and chronic conditions, and that this reduces the cost of care, improves patient adherence, and promotes continuity of care. 15 Primary care physicians in a survey study in Switzerland reported that the use of text messages improved patient follow-up.…”