The value of an advance notification letter prior to a postal offer of bowel cancer screening on population participation in screening.

Improved participation in screening for bowel cancer is desirable. Currently population scale bowel cancer screening program delivery is by mailed offer, without prior warning, from a central screening service and invitations include a occult blood kit. Invitees may reject this process as they are unprepared to receive such an offer. One approach is to improve communication between screening providers and invitees through improved population scale interpersonal contact. We have developed a preliminary letter to precede an postal invitation to bowel cancer screening. The letter simply informs invitees that they will soon receive a screening invitation and provides them with some basic information about bowel cancer screening. We will randomly select invitees from the electoral roll and compare population screening participation between groups with or without the preliminary letter to determine which program results in the greater participation rate. Improved participation in screening will ultimately reduce deaths from bowel cancer