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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Colorectal cancer is one of the leading causes of cancer deaths in Western nations. Although a substantial body of research evidence in favor of colorectal cancer screening has been gathered, and despite national guidelines recommending screening to all those over 50 years old, uptake of colorectal screening remains relatively low in the US. In both the USA and the UK primary care is the main point of entry into the health care system, with cancer screening being an integral component of primary care services in both countries. An effective colorectal cancer screening program requires the support of primary care but more evidence regarding primary care-based strategies to improve the delivery and uptake of such a program among lowest-uptake groups is needed. Following the completion of the Evaluation of the UK Colorectal Cancer Screening Pilot, this study examines the role of primary care in recruiting low-uptake groups in the population to FOBT screening. The study will deliver two targeted interventions which address barriers in low-uptake sub-groups identified in our evaluation, and in the literature. Two interventions will be piloted in this exploratory proposal: 1. a primary care-generated paper-based strategy: there has been little research on the use of paper-based strategies which specifically address the expressed barriers of FOBT screening invitees, and it is possible that the combined effect of primary care practice endorsement and the tailored nature of the material will produce an effect; further, paper-based strategies are less resource-intensive, and have the potential for widespread implementation. 2. Nurse facilitators: there is currently considerable interest in the use of appropriately trained nurse facilitators in delivering multifaceted interventions to improve prevention in primary care. Nurse facilitators will be trained in the specific cultural, social and other barriers identified in low-uptake sub-groups, and will be available as an information and support resource for invitees to screening, working closely with primary care practices.