Few studies have directly targeted nonparticipants in colorectal cancer screening to identify effective engagement strategies. We undertook a randomized controlled trial that targeted nonparticipants in a previous trial of average-risk subjects which compared participation rates for mailed invitations offering a fecal test, a blood test or a choice of either. Nonparticipants ( n = 899) were randomized to be offered a kit containing a fecal immunochemical test (FIT), directions on how to arrange a blood DNA test, or the option of doing either. Screening participation was assessed 12 weeks after the offer. To assess the cognitive and attitudinal variables related to participation and invitee choice, invitees were surveyed after 12 weeks, and associations were investigated using multinomial logistic regression. Participation rates were similar between groups ( P = 0.88): 12.0% for FIT (35/292), 13.3% for the blood test (39/293), and 13.4% for choice (39/290). Within the choice group, participation was significantly higher with FIT (9.7%, 28/290) compared with the blood test (3.8%, 11/290, P = 0.005). The only variable significantly associated with participation was socioeconomic status when offered FIT, and age when offered choice but there was none when offered the blood test. Survey respondents indicated that convenience, time-saving, comfort, and familiarity were major influences on participation. There was no clear advantage between a fecal test, blood test, or choice of test although, when given a choice, the fecal test was preferred. Differences in variables associated with participation according to invitation strategy warrant consideration when deciding upon an invitation strategy for screening nonparticipants. Prevention Relevance: This trial of screening for those at average risk for colorectal cancer targeted past fecal-test nonparticipants and compared participation rates for mailed invitations offering a fecal test, blood test, or choice of either. Although there was no clear advantage between strategies, factors associated with participation differed between each strategy.

中文翻译：

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结直肠癌筛查中非参与者的“拯救”：三种无创测试选项的随机对照试验

很少有研究直接针对结直肠癌筛查的非参与者来确定有效的参与策略。我们进行了一项随机对照试验，该试验针对之前的平均风险受试者试验中的非参与者，该试验比较了提供粪便测试、血液测试或两者之一的邮寄邀请的参与率。非参与者 (n = 899) 被随机分配到一个包含粪便免疫化学测试 (FIT) 的试剂盒、如何安排血液 DNA 测试的说明，或者可以选择做任何一个。筛选参与度在提供后 12 周进行评估。为了评估与参与和受邀者选择相关的认知和态度变量，12 周后对受邀者进行了调查，并使用多项逻辑回归调查了关联。各组之间的参与率相似（P = 0.88）：FIT (35/292) 为 12.0%，血液测试 (39/293) 为 13.3%，选择 (39/290) 为 13.4%。在选择组中，与血液测试（3.8%，11/290，P = 0.005）相比，FIT（9.7%，28/290）的参与度显着更高。与参与显着相关的唯一变量是提供 FIT 时的社会经济地位，以及提供选择时的年龄，但提供验血时则没有。调查受访者表示，方便、省时、舒适和熟悉是参与的主要影响因素。粪便测试、血液测试或测试选择之间没有明显的优势，尽管在选择时，粪便测试是首选。在决定筛选非参与者的邀请策略时，需要考虑根据邀请策略与参与相关的变量的差异。预防相关性：这项针对结肠直肠癌平均风险人群的筛查试验针对过去进行粪便检测的非参与者，并比较了提供粪便检测、血液检测或任何一种选择的邮寄邀请的参与率。尽管策略之间没有明显的优势，但与参与相关的因素在每种策略之间是不同的。或选择其中之一。尽管策略之间没有明显的优势，但与参与相关的因素在每种策略之间是不同的。或选择其中之一。尽管策略之间没有明显的优势，但与参与相关的因素在每种策略之间是不同的。