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The effects of promoting colorectal cancer screening on screening utilisation: evaluation of the German Campaign "Aktiv gegen Darmkrebs" (Action against Colorectal Cancer).

BACKGROUND
Although colorectal cancer is the second leading cause of cancer death in Germany, screening rates remain low. It is unknown whether local approaches to promoting colorectal cancer screening are effective. This study evaluates the effectiveness of a regional awareness campaign consisting of public information sessions and leaflet distribution, upon the use of colorectal cancer screening by faecal occult blood test (FOBT) and colonoscopy.


METHODS
Data on FOBT and colonoscopy were collected by doctors for 12 months following the campaign, including reason for and result of the testing. 37 % (n = 43) of all physicians and practitioners in two administrative districts (249 632 inhabitants) that were exposed to the campaign participated in the study. It was recorded whether the individuals requesting colorectal cancer screening had been prompted by the campaign, so the number and outcome of campaign-related tests was determined.


RESULTS
3398 individuals (male: 54.6 %, female: 45.4 %, age: 64.3 +/- 8.3 years) underwent 3551 screening tests (2446 FOBT, 819 colonoscopy, 133 both). 141 additional diagnostic colonoscopies were performed because of a positive result in the FOBT. Adenomas were detected in 279 individuals, malignancies in 11 individuals. 225 FOBT (8.7 %) and 176 colonoscopies (18.5 %) were performed due to the campaign; among these individuals, 49 had adenoma(s), 1 had carcinoma. The effect could be attributed both to leaflets and to information sessions. The proportion of campaign-related screening tests declined over time.


CONCLUSION
The regional information campaign could reach target individuals and motivate them to utilise colorectal cancer screening. The combination of mass media and personal communicative elements seems useful.