Improving uptake of bowel cancer screening (Phase 2)

Bowel screening can detect bowel cancer at an early stage in people with no symptoms when it is easier to treat and there is a significantly greater chance of survival. An effective screening programme can reduce mortality amongst the eligible population by 15%. Wales has the lowest uptake of bowel screening in the UK, with inequities in uptake of bowel screening in Wales present since the programme started in 2008.

Currently, everyone aged between 58 and 74 who is living in Wales is invited to take part in bowel cancer screening every two years. In 2018/19, the uptake rate for bowel screening in Wales was 57.3% with around 160,000 of 280,000 eligible people completing and returning their bowel cancer screening tests. Whilst there was also a narrowing of the inequalities gap between ages, gender and localities, there is still much to do to motivate more people to take part.

In the first phase of the Bowel Cancer Programme, Bowel Screening Wales piloted a range of interventions aimed at increasing uptake. This included a ‘non-responder’ project that targeted those who initially did not respond to the invitation to participate in bowel screening; this resulted in about 30% of the targeted non-responder group then participating in screening (across 1600 targeted).

Activity during the first phase also comprised a bilingual campaign to boost uptake of the new FIT test. This included a TV advert featuring ex-Lions and Wales international rugby player Jamie Roberts, which coincided with the 2020 six nations rugby tournament.

Following the success of phase 1, the next phase of work includes:

• Upscaling the use of GP endorsed invitations and reminder letters for bowel screening. Evidence has shown that the use of local GP endorsement of screening, by using letters that are issued in the name of the participant’s GP, improves uptake. In the first phase of the project, the use of a single GP endorsed reminder letter was shown to increase uptake by 9-22% amongst people who had initially not responded
• A dedicated analyst post to identify and interpret patterns in Bowel Screening Wales' and wider data, to inform ongoing service improvement, quality and effectiveness
• Co-producing bowel cancer screening programme information products with people with learning disabilities, to help more people feel comfortable to participate.

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