Overview
The ASCEND2 study was a follow-on study in 2016 to the ASCEND study from 2012-13. It involved 370,000 people who were invited to take part in the NHS Bowel Cancer Screening Programme in England.
Why was this study needed?
Bowel cancer is the third most common cancer in the UK, and the second most common cause of cancer death in the UK. Diagnosing bowel cancer early helps save more people from dying from this disease.
The English NHS Bowel Cancer Screening Programme was set up in 2006 to help prevent people dying from bowel cancer. Research like ASCEND2 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 ASCEND2 study?
Many people do not complete and return their poo tests. Not returning a test could mean that any early sign of bowel cancer showing in someone’s poo would be missed.
The earlier ASCEND study tested four ways to try and get more people to complete and return their poo tests. ASCEND2 looked more into one particular method, a special message from a person’s GP, to see if this would get more people everywhere to complete the test. This includes increasing participation from people living in poorer areas, where bowel cancer is more common.
How was the study carried out?
ASCEND2 was designed as a randomised controlled trial (RCT). In an RCT, people are randomly split between an intervention group (or test group) and no-intervention group. This lets scientists directly compare the two groups. Well-designed RCTs, such as ASCEND2, are thought to give the best evidence for whether something is effective or not.
The intervention group received a message from their GP along with the letter from the screening programme with their poo test kit. The no-intervention group received just the normal screening programme letter with their poo test kit.
No other aspects of the NHS Bowel Cancer Screening Programme were changed during the study. People received the same care as part of the screening programme whether or not they received an alternative invitation, or had their information used as part of the study.
When and where did this study take place?
The ASCEND2 study took place across England in 2016.
Who funded ASCEND2?
ASCEND2 was funded by Cancer Research UK.
What type of information does the CSPRG hold for the purposes of the ASCEND2 study?
The CSPRG does not hold personal data for the purpose of the ASCEND2 study. Please see our ‘How we protect your patient data’ 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?
The special message from GPs helped increase the number of people completing the poo test by a small amount everywhere. It did not show a greater increase of completed tests from people living in poorer areas. More research is needed for how best to encourage this group to return their tests.
The ASCEND2 study results were published in the Journal of Medical Screening in 2021.
We hope the results will be used to help the NHS Bowel Cancer Screening Programme with how best to encourage people to complete and return their poo tests. The poo test is a proven method for detecting bowel cancer early and saving lives from this disease.