More than half of England’s poorest citizens risk undetected bowel cancer

The study was set up to test ways of narrowing the gap in uptake between rich and poor. The results highlight just how wide this gap currently is, and also provide the first published national figures on bowel screening uptake since the scheme was fully rolled out in 2010. Four randomised controlled trials were conducted across the whole of England to see if uptake could be increased, particularly among the most disadvantaged members of society, by making cheap, simple and easy-to-implement changes to the screening invitation letters and information materials. This involved either making minor changes to the wording of invitation letters and reminders, or adding supplementary information materials. The results showed that adding a line to the reminder letter emphasising the importance of screening had a greater effect among poorer recipients, narrowing the gap between rich and poor, while also improving uptake overall by about 1%. Adding a line to invitation letters mentioning the support of the recipient's GP Practice also increased overall uptake by about 1%, but did not narrow the gap between rich and poor. Adding booklets with simplified information, or stories about screening from individuals who had taken part, were found to increase knowledge and motivation in earlier pilot studies, but ultimately failed to make any impact on uptake.