Are deadlines the secret to increasing colorectal cancer screening rates? The TEMPO trial, a nationwide randomized controlled trial in Scotland, evaluated the impact of two behavioral interventions on colorectal cancer screening uptake. These interventions included adding a deadline for returning faecal immunochemical tests (FIT) and using a problem-solving planning tool. The study found that including a deadline in the invitation letter significantly increased timely FIT returns and reduced the need for reminder letters. The planning tool had no positive effect. A 2-week deadline was identified as the most effective and acceptable option.

Key Insights from the TEMPO Trial

• Deadline Effectiveness. Adding a deadline to the FIT invitation letter increased timely returns and reduced the need for reminder letters. The 2-week deadline was particularly effective in enhancing colorectal cancer screening rates.
• Planning Tool Ineffectiveness. The planning tool did not improve FIT return rates and was even detrimental when used without a deadline.
• Cost-Effectiveness. The deadline intervention is highly cost-effective, requiring minimal additional resources.

Understanding the Colorectal Screening Landscape

Colorectal cancer screening uptake is suboptimal globally, with about 50% participation in European FIT programs. Interventions like deadlines and planning tools could enhance participation. The TEMPO trial is the first to assess these interventions within a nationwide screening program.

Strategic Implications and Future Directions

Implementing deadlines could increase FIT returns and potentially save lives by facilitating earlier detection of colorectal cancer. Reducing reminder letters can lead to substantial cost savings for screening programs. Further studies should explore the effectiveness of deadlines in other screening contexts. They should also assess potential barriers to implementation, such as literacy levels and language barriers. For more insights into the effectiveness of these interventions, you can explore the article on The Lancet’s website here.