Additional mailing phase for FIT after a medical offer phase: the best way to improve compliance with colorectal cancer screening in France

Abstract Background Compliance with colorectal cancer screening is critical to its effectiveness. The organization of the mass screening program in France has recently been modified with no evaluation of the consequences. Aims To evaluate the impact of the way the screening test is delivered on compliance. Patients and methods During the first six months of the screening campaign (Ille-Vilaine, Brittany), general practitioners were asked to propose a faecal immunochemical test (FIT), OC-Sensor, to individuals at average risk for colorectal cancer (n = 152,097). A subset of non-participants in the medical phase (n = 13,071) was randomly chosen to receive a reminder that included the screening test or a simple postal reminder without the screening test. Results Compliance was 31% if the screening test was proposed during a medical consultation. In non-participants during the medical phase, it was 45% in those receiving both a reminder and the screening test and 28% among those receiving a simple reminder. An estimated overall participation rate of 54% can be expected if non-participants in the medical phase are sent a reminder together with the screening test. Conclusion In France, a compliance rate above the minimum uptake rate of 45% recommended by European Union experts can be achieved if the FIT is mailed to non-participants after the medical free-offer phase.