Our penultimate blog comes from Prof Bob Steele, Clinical Director, Scottish Bowel Screening Programme and our very own co-director. He has chosen a paper which discusses an innovative approach to improving rates of bowel screening in a disadvantaged population, a challenge that’s very pertinent to us here in Scotland.

Title: Comparative Effectiveness of a Multifaceted Intervention
to Improve Adherence to Annual Colorectal Cancer Screening
in Community Health Centers

Authors: David W. Baker, Tiffany Brown, David R. Buchanan,  Jordan Weil, Kate Balsley, Lauren Ranalli et al.

Weblink: http://archinte.jamanetwork.com/article.aspx?articleid=1881011

Why is this paper important?

My paper of the year comes from Chicago where the authors describe an intervention to increase colorectal cancer screening rates amongst Latinos and individuals living in poverty.  The screening programme employed home faecal immunochemical tests (FIT) distributed at Health Centres and the intervention consisted of a reminder letter, automated telephone and text messages and personal telephone outreach.  Uptake of screening rose to 82.2 % of the intervention group compared with 37.3 % in those experiencing usual care.  This paper describes the most impressive increase in uptake of any published intervention and the authors argue that it is possible to improve colorectal cancer screening for vulnerable populations with relatively low costs strategies.  In this country such an intervention may be viewed as overly burdensome and counter to the principles of informed consent.  Nonetheless, it is clearly highly effective and serious consideration should be given to adopting this approach, at least in a research context.