INSIGHT – Increasing Screening In Groups Hard to Reach with Targeting
Research type
Research Study
Full title
Increasing the uptake of national screening programmes with smart targeting of low-uptake subgroups
IRAS ID
364387
Contact name
Gaby Judah
Contact email
Sponsor organisation
Imperial College London
ISRCTN Number
ISRCTN13515216
Duration of Study in the UK
1 years, 9 months, 1 days
Research summary
This study aims to increase attendance for cervical and lung cancer screening by improving how people are invited to appointments, particularly among groups with historically low uptake.
Cervical screening is offered every five years to people aged 25–64 with a cervix. Lung cancer screening is offered every five years to adults aged 55–74 with a history of smoking. National uptake remains below target: around 72% for cervical screening (target 80%), and 49% for lung screening (target 53%).
Disparities in screening uptake are well documented. People living in more deprived areas, those from Black, Asian, and other minority ethnic backgrounds, individuals with limited English proficiency, and people with lower access to services are all less likely to attend screening. Existing invitation systems often rely on individuals to take action to book appointments, and do not always address these access barriers.
This study evaluates a structured and standardised communication service developed by Appt Health. The platform integrates with NHS systems to send appointment invitations via SMS or letter. It offers two levels of communication:
• Appt Standard, where patients receive standardised and structured invitations via NHS App notifications, emails, SMS, or letter, including a direct booking link and reply-to-book SMS options. Letter invitations invite the users to call their GP practice to book an appointment.
• Appt Targeted, encompassing the ‘Standard’ offering but adapts messaging format, tone, timing, and language for specific subgroups with lower uptake.The study will be conducted in 200-500 GP practices across England. Participants will be allocated at practice level to usual care, Appt Standard, or Appt Targeted. The study will evaluate whether these different invitation strategies improve screening uptake. Targeted invitations will be developed with public contributors through co-design workshops. No new clinical procedures are involved, and no additional patient consent is required for receiving invitations, as this represents usual care.
REC name
South West - Frenchay Research Ethics Committee
REC reference
26/SW/0031
Date of REC Opinion
7 May 2026
REC opinion
Further Information Favourable Opinion