P18 The SUMMIT study: uptake from re-invitation

Introduction and Objectives The SUMMIT Study aims to assess the implementation of low-dose Computed Tomography (LDCT) for lung cancer screening (LCS) in a high-risk population and to validate a multi-cancer early detection blood test. Invitees are identified via primary care records and invited to attend a Lung Health Check (LHC), where if eligible, LDCT is offered. Uptake of LCS has been low, whilst UK studies have demonstrated higher rates, these are still lower than other screening programmes. Research in other cancer screening settings suggests that re-invitation strategies improve uptake among non-responders, with recall routine practice in existing national screening programmes. We aim to quantify the uptake to re-invitation, something not previously tested in the LDCT screening context. Methods Re-invitation and re-invitation reminder letters were sent to individuals who had not responded to the initial series of invitation letters (pre-invitation, invitation, reminder) within four months or longer. The content of the letters was designed using behavioural science evidence for strategies effective for non-responders in the colorectal cancer screening context, including the principles of scarcity, social norms for participation so far, personalisation to local London borough and GP endorsement. Responses from the first ten re-invited practices were analysed. Re-invitations were sent between 22nd January and 5th February 2020 and reminders between 5th and 19th February 2020. Data were analysed 21 days after the last reminder was sent. Results 2,000 non-responders were sent re-invitation letters. 310 (15.5%) of those re-invited responded (range: 8.3%–21.2% per practice). The average response time was 19 days. Of those who responded, 186 (60.0%) were eligible for a LHC and 182 (97.8%) of those eligible booked a LHC appointment. Four people (2.2%), did not attend their booked appointment. Of those attending, 154 (86.5%) were eligible, of which 133 (86.4%) consented. Conclusions The re-invitation strategy impacted positively on screening uptake and participation by non-responders. These results may be an underrepresentation of the true effect, as invitees could contact the study team after the date of analysis. Work continues to assess the demographic and smoking-related characteristics of those who respond to re-invitation and how it interacts with the overall invitation strategy.