Using screening practitioners as navigators in the Bowel Scope Screening Programme: a feasibility study

Abstract

Background: The Bowel Scope Screening (BSS) programme in England invites people aged 55 for a once only flexible sigmoidoscopy. Participation is generally low (43%) which limits its ability to reduce colorectal cancer incidence and mortality. Previous research has identified many barriers to receiving BSS. We aimed to assess the feasibility of using screening practitioner led patient navigation (PN) calls to provide BSS non-attenders with practical and emotional support to overcome barriers and facilitate attendance. Methods: Individuals invited to attend BSS at South Tyneside District Hospital (STDH), UK, were sent a study invitation alongside their standard BSS invitation letter (n=1050). Consenting individuals were randomised to one of two groups: usual care or PN. Only those in the PN group who then failed to attend their BSS appointment were eligible to receive a PN call. Screening practitioners were asked to feedback on their role in the study. Findings: Our study recruitment was substantially lower than expected (14.6% vs. 40%). Of the 153 people who consented to take part in the study, only 22 were eligible for PN. Due to various practical difficulties e.g. unanswered/declined calls (n=13), only 2 participants received PN: one rebooked and attended a BSS appointment and one was not eligible for BSS. Discussion: The opt-in recruitment process was necessary to obtain the phone numbers of BSS non-attenders, but was not a feasible approach. Future research will investigate alternative routes to identifying and contacting BSS non-attenders (e.g. through primary care) so that the impact of PN itself be evaluated.