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Behaviour change

Contemplating cancer screening

Nature Reviews Psychology (2024)Cite this article

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Cancer screening can save lives through early detection, and optimized uptake of screening maximizes population-level benefits. Seemingly small improvements in screening participation through behavioural intervention have considerable implications in practice, including saving lives and reducing health system spending.

When testing the effects of invitational strategies in the colorectal cancer screening context, completion and return of a home screening test kit is often the outcome of interest. Early studies in the 1980s and 1990s used advance notification letters alongside other strategies to invite participation. In 2007, Cole and colleagues conducted a community trial to test the efficacy of three different mailed invitational strategies against a control condition of a standard invitation letter, each accompanying a home testing kit. The primary outcome was return of the completed testing kit by 12 weeks after the screening invitation. Importantly, return rates were significantly higher among the randomly assigned invitees who were mailed an advance notification letter two weeks before the control materials. This significant difference persisted after accounting for the two weeks of extra lead time in the advance notification condition. In a later study, Zajac and colleagues targeted advance notification letters specifically for men to further improve screening participation in this under-screened group.

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References

Original article

  • Cole, S. R. et al. An advance notification letter increases participation in colorectal cancer screening. J. Med. Screen. 14, 73–75 (2007)

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Acknowledgements

The author is supported by a PhD scholarship at Flinders University provided through Medical Research Future Fund GNT2008603 and receives cancer screening-related research funding from Flinders Foundation and Tour de Cure. This publication is solely the responsibility of the contributing author and does not reflect the views of the funding bodies.

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  1. Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

    Nathan J. Harrison

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  1. Nathan J. Harrison
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Correspondence to Nathan J. Harrison.

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The author declares no competing interests.

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Harrison, N.J. Contemplating cancer screening. Nat Rev Psychol (2024). https://doi.org/10.1038/s44159-024-00316-x

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  • DOI: https://doi.org/10.1038/s44159-024-00316-x

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