Uptake of Bowel Scope (Flexible Sigmoidoscopy) Screening in the English National Programme: the first 14 months

Abstract

OBJECTIVE: To examine uptake in the first six pilot centres of the English Bowel Scope Screening (BSS) programme, which began in early 2013 and invites adultsaged 55 for a one off Flexible Sigmoidoscopy. METHODS: Between March 2013 and May2014 the six pilot centres sent 21,187 invitations. Using multivariate logisticregression analysis, we examined variation in uptake by gender, socioeconomicdeprivation (using the Index of Multiple Deprivation), area-based ethnicdiversity (proportion of non-white residents), screening centre, and appointment time (routine: daytime vs out-of-hours: evening/weekend). RESULTS: Uptake was43.1%. Men were more likely to attend than women (45% vs 42%; OR 1.136, 95% CI1.076, 1.199, p < 0.001). Combining data across centres, there was asocioeconomic gradient in uptake, ranging from 33% in the most deprived to 53% inthe least deprived quintile. Areas with the highest level of ethnic diversityalso had lower uptake (39%) than other areas (41-47%) (all p < 0.02), but therewas no gradient. Individuals offered a routine appointment were less likely toattend than those offered an out-of-hours appointment (42% vs. 44%; OR 0.931, 95%CI 0.882, 0.983, p: 0.01). Multivariate analyses confirmed independent effectsof deprivation, gender, and centre, but not of ethnic diversity or appointmenttime. CONCLUSION: Early indications of uptake are encouraging. Future effortsshould focus on increasing public awareness of the programme and reducingsocioeconomic inequalities.

Publication
Journal of Medical Screening
Gianluca Baio
Gianluca Baio
Professor of Statistics and Health Economics