Return to bowel screening after a false-positive faecal immunochemical test in BowelScreen (the National Bowel Screening Programme in Ireland)

Abstract

Objective Little research exists on what predicts individual return to screening after a false-positive faecal immunochemical test in a population bowel screening programme. We aimed to quantify the impact of false-positive faecal immunochemical test in the first round of screening on re-attendance in BowelScreen, the National Bowel Screening Programme in Ireland. Methods A retrospective cohort study was conducted. False-positivity was defined as a positive faecal immunochemical test with subsequent colonoscopy showing no evidence of malignancy or surveillance requirement. In those with a false-positive faecal immunochemical test, logistic regression was used to predict repeat participation in the second round. Results Of 196,149 individuals who attended the first screening round, 108,075 were eligible and re-invited in the second round, and 93,971 accepted the invitation (86.9%). Second round uptake was higher in faecal immunochemical test-negative individuals compared with those having false-positive results (87.5% vs. 73.1%; p < 0.001). Older age (odds ratio (OR) 0.75; 95% confidence interval (CI) 0.60–0.94), computed tomography colonography (unsuitability/failed colonoscopy) (OR 0.40; 95% CI 0.21–0.73), and longer duration from screening invitation to faecal immunochemical test result (OR 0.991; 95% CI 0.9872–0.995) were predictors of non-re-attendance in the next screening round. Conclusion There is a significant reduction in re-attendance rates for individuals with false-positive faecal immunochemical test results. The letter sent following a negative colonoscopy is being reviewed to ensure that it provides adequate encouragement to re-attend. There are roles for screening promotion and for Gastroenterologists and Advanced Nurse Practitioners to emphasize the importance of regular faecal immunochemical tests after a negative colonoscopy.

How is equity captured for colorectal, breast and cervical cancer incidence and screening in the Republic of Ireland: A review

“…Twelve studies investigated incidence differences ( Table 2 ) ( Balhareth et al, 2018 , Clarke et al, 2014 , Donnelly et al, 2013 , McDevitt et al, 2017 , National Cancer Registry Ireland, 2018a , National Cancer Registry Ireland, 2022a , O'Brien and Sharp, 2013 , Sharp et al, 2014 , Ullah et al, 2018 , Walsh et al, 2016 ). Twenty-four investigated differences in screening participation ( All Ireland Traveller Health Study Team, 2010 , Barrett et al, 2011 , Central Statistics Office, 2020 , Ch'ng et al, 2019 , Clarke et al, 2016 , Codd et al, 1994 , Connolly and Whyte, 2019 , Fitzpatrick et al, 2011 , Fleming et al, 2013 , Gallagher and Gallagher, 2010 , Lalor and Redmond, 2009 , McCarron et al, 2011 , McNamara et al, 2014 , McNamara et al, 2011 , Moore et al, 2017 , National Screening Service, 2020a , National Screening Service, 2020b , National Screening Service, 2021 , National Screening Service, 2022 , Ní Riain et al, 2001 , O'Brien et al, 2018 , Pavee Point Traveller and Roma Centre & Mid West Traveller Health Unit, 2019 , Walsh et al, 2010 , Walsh et al, 2012 ). Twenty studies reported on breast cancer, 16 on colorectal cancer and 15 on cervical cancer.…”

“…Participation was higher in the 50–59 age group compared to the 60 + age group.Cervical: in all ages, 22.7% reported attending for cervical screening in the last 12 months compared to 11.6% from the medical card population in the SLAN study. AACODS, high ( Ch'ng, Mooney, O'Donoghue, & Fitzpatrick, 2019 ) Individuals aged 60–69 who received a negative (n = 105,276) or false-positive (n = 1,999) FIT (colorectal screen) in Ireland. To quantify the impact of false-positive FIT in the first round of screening on re-attendance in colorectal screening.…”

“…However, two studies found older age was associated with higher participation ( Clarke et al, 2016 , McNamara et al, 2014 ). Older age also contributed to reduced likelihood of return to colorectal screening after false-positive results compared to individuals with negative results ( Ch'ng et al, 2019 ).…”