Comparison of mailed invitation strategies to improve fecal occult blood test participation in men: protocol for a randomized controlled trial

Amy Duncan, Ian Zajac, Ingrid Flight, Benjamin Stewart, Carlene Wilson, Deborah Turnbull

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)


    Background: Men have a significantly increased risk of being diagnosed with, and dying from, colorectal cancer (CRC) than women. Men also participate in fecal occult blood test (FOBT) screening at a lower rate than women. This study will determine whether strategies that target men's attitudes toward screening, and matched to stage of readiness to screen, increase men's FOBT participation compared to a standard approach.Methods/Design: Eligible trial participants will be a national sample of 9,200 men aged 50 to 74 years, living in urban Australia and randomly selected from the Australian electoral roll. Trial participants will be mailed an advance notification letter, followed 2 weeks later by an invitation letter and a free fecal immunochemical test (FIT) kit. The intervention is a factorial design, randomized controlled trial (RCT) with four trial arms, including a control. The content of the advance notification and invitation letters will differ by trial arm as follows: 1) standard advance notification and standard invitation (control arm); 2) targeted advance notification and standard invitation; 3) standard advance notification and targeted invitation; and 4) targeted advance notification and targeted invitation. The standard letters will replicate as closely as possible the letters included in the Australian National Bowel Cancer Screening Program (NBCSP). Modified advance notification and invitation letters will incorporate additional messages to target men in the precontemplation (advance notification) and contemplation stages (invitation). The primary outcome is return of the completed FIT within 12 weeks of invitation. Analysts will be blinded to trial assignment and participants will be blinded to the use of varying invitational materials. Subsamples from each trial arm will complete baseline and endpoint surveys to measure the psychological impact of the intervention, and qualitative interviews will be conducted to evaluate attitudes toward the intervention.Discussion: The outcomes of this study will have implications for the way FOBT screening is offered to men. Findings will help to identify how invitations for men to screen should be framed and delivered in order to maximize participation.

    Original languageEnglish
    Article number239
    Pages (from-to)239
    Number of pages9
    Issue number1
    Publication statusPublished - 31 Jul 2013


    • Colorectal neoplasm
    • Male
    • Mass screening methods
    • Protocol
    • Psychological factors
    • Randomized controlled trial


    Dive into the research topics of 'Comparison of mailed invitation strategies to improve fecal occult blood test participation in men: protocol for a randomized controlled trial'. Together they form a unique fingerprint.

    Cite this