Overview
The ASCEND study was led by University College London in collaboration with Imperial and took place between 2012-2013. It involved 750,000 people who were invited to take part in the NHS Bowel Cancer Screening Programme in England.
Why was this study needed?
In the UK over 40,000 people get bowel cancer every year. Over 16,000 die from the disease. Studies suggest that testing or screening the general population can help identify cancer earlier, when treatment is much more likely to be successful and save lives.
The English NHS Bowel Cancer Screening Programme was set up in 2006 to try help prevent people dying from bowel cancer. Research like ASCEND provides evidence to help the screening programme save more lives.
What does the NHS Bowel Cancer Screening Programme do?
Every two years the NHS Bowel Cancer Screening Programme sends a poo test kit to everyone aged 50 to 74 years old. The test is to look for blood in poo, which can sometimes be a sign of bowel cancer. The test kit is completed at home and then returned in a prepaid envelope to a screening centre to be examined. If a certain amount of blood is found in the poo, the person is invited to come to a hospital for more tests for bowel cancer.
What were the aims of the ASCEND study?
It has been estimated that the risk of dying from bowel cancer is reduced by about 25% in people who regularly complete and return their poo test kits. But not everyone who is sent a test kit completes and returns it. Research suggests that people living in poorer areas are the least likely to do the test. This is a worry because they are more likely to die from bowel cancer.
People deciding whether to do the poo test or not could be influenced by how they are asked the complete the test and what information they are given about it.
For people living in poorer areas, the ASCEND study looked to find out if there was a particular way of getting more people to do the test.
How was the study carried out?
ASCEND was a comparison study. We tested four new ways of inviting people to do the poo test against the normal way used by the Bowel Cancer Screening Programme. We wanted to see if any of the four other ways could be more successful than the normal way.
During the study, people invited to do the poo test might have received, at random, one or a combination of the following:
- The normal bowel cancer screening invitation letter.
- A simple, short leaflet about the poo test.
- A leaflet with more information including what some people who had already done the poo test had to say about it.
- A statement from the patient’s GP practice about the benefit of doing the poo test to prevent cancer and encouraging them to do it.
- A reminder letter to those people who had already been invited to do the poo test before and had not done it.
When and where did this study take place?
The ASCEND study took place across England between 2012 and 2013.
Who funded the ASCEND study?
This project was funded by the National Institute for (NIHR) Programme Grants for Applied Research programme.
What type of information does the CSPRG hold for the purposes of the ASCEND study?
The CSPRG does not hold personal data for the purpose of the ASCEND2 study. Please see our 'How we protect your patient data' section for general information about our use of patient data for our cancer research and our Data Protection and Privacy Notice.
What are the results of the study and what impact have they had?
Only one of the methods tested, the reminder letter, increased the likelihood of people in poorer areas completing the poo test. We also found that the GP practice encouragement method slightly increased the likelihood that people in all areas would do the poo test.
It is hoped that the ASCEND study evidence will help the NHS Bowel Cancer Screening Programme reduce the risk of bowel cancer for everyone, including people living in poorer areas.
The findings of the ASCEND study were published in several journals including The Lancet. They are also available on the University College London website.