Holiday and Birthday Reminders Increase Screenings

People are more likely to get a colorectal cancer screening if it is scheduled during December or around their birthdays.  Norwegians who received an invitation from the  Norwegian Colorectal Cancer Prevention Trial to come in for a sigmoidoscopy in December kept that appointment more often than in any other month.

Reminders sent the week of a person’s birthday also increased the possibility that they would keep their appointment.

The Norwegian Colorectal Cancer Prevention Trial 1 invited almost 21,000 randomly selected residents of urban Oslo or the urban and rural areas around Telemark to come into a center for sigmoidoscopy colorectal cancer screening.  About 2 of every 3 people invited kept their appointments, nearly 13,000 or 65 percent.

  • 67.9 percent of those who were invited during the week of their birthday or scheduled to have their screening in the two weeks after their birthday kept their appointment, compared to 64.5 percent of those invited or scheduled at other times.
  • December was an even stronger draw.  72.3 percent complied with the request compared to 64.6 percent in other months.

The researchers speculated that birthdays and year-end holidays are reminders of aging.  Although age was not mentioned in the screening invitations, birthdays and holiday milestones are often times that people reflect on increasing age.  Another explanation is that many people approach such milestones with an idea of “getting things done” or taking care of “housekeeping business.”

Because of an almost 10 percent increase in screening compliance in December, they suggest that expanding hours to accommodate more people during that month might be a good strategy.

The research team points out that their results might not be as strong in outside of Norway.  The trial focused on flexible sigmoidoscopy, and in Norway there is no prior bowel cleansing preparation necessary.  A sorbitol enema is given at the screening center just before the exam.  Norwegian national health insurance also covers the cost of the test.

The team concluded,

Attendance rates for screening for colorectal cancer were higher in December and around attendees’ birthdays, the latter particularly in an urban population. Compliance with screening programmes may therefore be improved by timing invitations in proximity to annual milestones.

SOURCE: Hoff et al., British Medical Journal, Volume 337, Number 7684, December 20, 2008.

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