The influence of initial screening test technology on participation in rescreening for colorectal cancer

Colorectal cancer population screening programs commonly suffer from poor participation. Therefore it is important to reduce as many barriers as possible. Some screening tests affect participation, this is associated with level of technology. As screening most effective when conducted regularly, it is important to determine the impact of the initial screening experience on participation in further rounds. This study determined the impact of the level of technology of the test used in the first round of offers on participation in a second round where all people were offered the test that elicited the highest participation in the first round (ie the 'preferred' test. In the first round there were 3 groups each offered sceening using a different test. Intervention group 1 used Hemoccult II Sensa, a low technology guaiac based test requiring restricted diet for 6 days, sampling stool by spatula and 6 applications of stool to collection device, Intervention group 2 used FlexSure OBT, a mid level technology immunochemical test without restricted diet, sampling stool by spatula, 3 applications of stool to collection device, Intervention group 3 used InSure OBT, high level technology- immunochemical test, without diet, sampling stool by brush, 2 applications of stool sample. Intervention group 3 (InSure) returned the highest participation and was thus considered the preferred test. All people received Insure in the second round of offers.