General practice endorsement in the Bowel Cancer Screening Programme

ISRCTN ISRCTN11660314
DOI https://doi.org/10.1186/ISRCTN11660314
Secondary identifying numbers 1.0 17/03/2015
Submission date
21/04/2015
Registration date
16/07/2015
Last edited
09/08/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Bowel cancer is the second most common cause of cancer death in the UK. Early diagnosis improves survival and in light of this the NHS established the Bowel Cancer Screening Programme (BCSP). This Programme offers screening using a stool testing kit (the faecal occult blood test) to 60-74 year olds. Data from 2012 shows that only 53% of those offered screening take it up and that this varies from more than 60% in the most socially advantaged areas of the country to less than 35% in the most disadvantaged areas. This study aims to increase uptake in the BCSP, and to reduce differences in uptake between the most and least socially advantaged groups, whilst ensuring that uptake does not decline in any socioeconomic (SE) group. The study will test whether or not receiving an endorsement from your GP at the same time that you receive a kit as part of the BCSP is likely to increase uptake and/or reduce SE inequalities.

Who can participate?
Individuals who are routinely invited for screening in the BCSP (age 60-74 with a registered GP).

What does the study involve?
Participants will be randomly allocated either to receive an invitation letter with a GP endorsement or the standard letter currently sent out by the BCSP without an endorsement.

What are the possible benefits and risks of participating?
No benefits or risks are expected as the study is carried out within the participant’s standard care pathway as part of the Bowel Cancer Screening Programme – the usual benefits and risks of participating in the Bowel Cancer Screening Programme would still apply.

Where is the study run from?
Imperial College London (UK)

When is the study starting and how long is it expected to run for?
March to December 2015

Who is funding the study?
University College London (UK)

Who is the main contact?
Dr Amanda Cross

Study website

Contact information

Dr Amanda Cross
Scientific

Cancer Screening and Prevention Research Group
Department of Surgery and Cancer
Imperial College London, St Mary’s Campus
Room 505, Medical School Building
Norfolk Place
London
W2 1PG
United Kingdom

ORCiD logoORCID ID 0000-0002-0893-2377

Study information

Study designInterventional randomised controlled trial
Primary study designInterventional
Secondary study designCluster randomised trial
Study setting(s)Other
Study typeScreening
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleGeneral practice endorsement in the Bowel Cancer Screening Programme: the ASCEND2 project
Study acronymASCEND2
Study hypothesisReceiving an endorsement from the GP at the same time that you receive a screening kit as part of the NHS Bowel Cancer Screening Programme (BCSP) is likely to increase uptake rates and reduce socioeconomic (SE) inequalities in uptake.
Ethics approval(s)East Midlands REC, 07/12/2015, ref: 15/EM/0561
ConditionColorectal cancer/bowel cancer
InterventionASCEND2 will compare the effectiveness of using a general practice endorsement banner on kit invitation letters sent as part of the BCSP, against the standard letter currently sent out by the BCSP. Individuals who are routinely invited for screening in the BCSP in England will be allocated to receive an intervention on randomly selected days within a pre-specified time period (cluster randomisation).
Intervention typeBehavioural
Primary outcome measureProportion of people in each Index of Multiple Deprivation (IMD) quintile returning an adequate faecal occult blood test (FOBt) within 18 weeks of being sent their initial invitation letter. An adequate FOBt in this study is defined as reaching a definitive FOBt outcome of either a 'Normal' (no further clinical investigation is required) or 'Abnormal' (referral for prospective colonoscopy).
Secondary outcome measures1. Time taken to return FOBt by IMD quintile
2. Proportion of spoilt kits and their relationship to IMD quintile
3. Proportion of non-delivered kits by IMD quintile
4. Incremental cost per screening invitation
5. Incremental cost per screening invitation, both by IMD quintile and overall
6. All of the above outcomes analysed using other SE variables
Overall study start date01/03/2015
Overall study end date30/04/2018

Eligibility

Participant type(s)Other
Age groupSenior
SexBoth
Target number of participants97616
Total final enrolment394842
Participant inclusion criteriaMen and women aged between 60-74 years who have a registered GP
Participant exclusion criteria1. We will only be able to randomise eligible people to receive this intervention if they are registered with practices that agreed to endorse the BCSP during the preceding trial, ASCEND.
2. Invited subjects may contact their BCSP hub and opt-out of the current screening episode and others for reasons of informed choice or poor health and they can choose to be ceased from the screening programme. 'Ceased' subjects, if ceased prior to their screening due date will not be invited to be screened.
Recruitment start date01/02/2016
Recruitment end date11/03/2016

Locations

Countries of recruitment

  • United Kingdom

Study participating centre

NHS Bowel Cancer Screening Programme
-
United Kingdom

Sponsor information

Imperial College London (UK)
University/education

South Kensington
London
SW7 2AZ
England
United Kingdom

ROR logo "ROR" https://ror.org/041kmwe10

Funders

Funder type

University/education

University College London
Government organisation / Universities (academic only)
Alternative name(s)
University College London in United Kingdom, Collegium Universitatis Londinensis, UCL
Location
United Kingdom

Results and Publications

Intention to publish date30/04/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planCurrent publication and dissemination plan as of 11/07/2018:
Analysis and results publication expected in 2018-2019.
IPD sharing planThe datasets generated during and/or analysed during the current study are not expected to be made available. Source data contains patient identifiers and is the property of the NHS BCSP so will therefore not be freely available. Once processed, cleaned and anonymised study data will then be stored in a repository as per sponsor (Imperial College) guidelines.

Previous publication and dissemination plan:
Analysis and results publication expected in 2017.

IPD sharing statement:
The datasets generated during and/or analysed during the current study is not expected to be made available. Source data contains patient identifiers and is the property of the NHS BCSP so will therefore not be freely available. Once processed, cleaned and anonymised study data will then be stored in a repository as per sponsor (Imperial College) guidelines.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 27/02/2021 11/03/2021 Yes No
Protocol file version 1.0 11/11/2015 09/08/2022 No No
HRA research summary 28/06/2023 No No

Additional files

30620 ASCEND2 Protocol v1.0 11Nov2015.pdf

Editorial Notes

09/08/2022: Uploaded protocol (not peer-reviewed) as an additional file.
11/03/2021: Publication reference and total final enrolment added.
15/02/2019: Contact details updated, trial website added.
11/07/2018: The following changes have been made:
1. The trial end date has changed from 31/12/2017 to 30/04/2018.
2. The publication and dissemination plan has been updated.
3. The intention to publish date has been changed from 31/12/2017 to 30/04/2019.
16/08/2017: Trial end date changed from 31/08/2016 to 31/12/2017. IPD statement clarified.
24/03/2016: Ethics approval information added.
12/11/2015: Following changes made: 1. The recruitment start date was changed from 06/07/2015 to 01/02/2016. 2. The recruitment end date was changed from 31/07/2015 to 11/03/2016. 3. The overall trial end date was changed from 31/12/2015 to 31/08/2016.