Which is more effective at improving uptake of bowel cancer screening: text message reminders or patient navigation? Results from a three-arm RCT
In brief
Text reminders and navigation tripled bowel screening uptake, with no clear winner
In a London trial of people who had not completed bowel screening, uptake by 26 weeks was 6.5% with text reminders and 7.5% with navigation, versus 2.0% with usual care; the trial found no significant difference between the two approaches. Per-protocol results favored navigation, especially among men, but whether it can narrow sex differences in screening remains to be tested.
- Journal
- British journal of cancer (Q1)
- Published
- 5 November 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Benzeer Siddique, Thomas Duffy, Natalie Gil, Andrew Prentice, Sarah Marshall, Natasha Djedovic, et al.
- PMID
- 42988857
- DOI
- 10.1038/s41416-026-03645-1
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 8 November 2026): RCT comparing text reminders vs navigation for bowel screening
Abstract
BACKGROUND: Text message reminders (TMRs) and patient navigation (PN) increase bowel cancer screening uptake. To date, no studies have directly compared these interventions with one another. METHODS: We conducted a three-arm randomised controlled trial with individuals, in London, who had not completed bowel cancer screening within 18 weeks of invitation. Participants were randomised to receive no reminder (usual care), TMRs at 19, 21, 23 and 25 weeks, or a TMR at 19 weeks, with telephone PN at 21, 23 and 25 weeks. The primary outcome was participation within 26 weeks of invitation. Differences were assessed using logistic regression. RESULTS: On an intention-to-treat basis (n = 3129), uptake was higher in the TMR and PN groups, compared with usual care (6.5% vs. 2.0%, p < 0.001; 7.5% vs. 2.0%, p < 0.001). There was no significant difference between TMR and PN groups. In the per-protocol analysis (n = 2294), uptake was significantly higher in the PN group than the TMR group (8.6 vs. 12.6%, p < 0.025). Subgroup analyses revealed telephone PN was significantly more effective than TMRs for men, specifically (14.5% vs. 6.7%, p < 0.001). CONCLUSIONS: While TMRs are no more effective than PN in general, implementing PN could help reduce disparities in uptake between men and women. TRIAL REGISTRATION: ISRCTN17245519.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.