Using Patient Navigation to Promote Bowel Screening in AAA Attendees.

Bowel cancer is a leading cause of cancer-related mortality in England. Biennial Faecal Immunochemical Test (FIT) screening can reduce bowel cancer-related deaths by detecting cases before symptoms develop. However, uptake remains suboptimal, particularly among men. Evidence from a single-centre study in Scotland suggests that a brief intervention, akin to patient navigation, delivered to men attending routine abdominal aortic aneurysm (AAA) screening appointments, can facilitate participation.

The overarching aim of this study is to evaluate the efficacy, feasibility, acceptability and cost-effectiveness of implementing patient navigation intervention across AAA screening services in England.

This study will be a single-arm, multi-centre feasibility study that will be conducted across five AAA screening centres in England, i.e. Leicester, Birmingham and Black Country, London, West Yorkshire, and Somerset and North Devon. Over a three-month period (August-November 2026), AAA screening practitioners will deliver patient navigation to a sample of approximately 4190 men, aged 65+ years, who attend AAA screening and self-report as bowel screening non-responders.

The primary outcome of the study is completion of a FIT kit within three months of the AAA appointment. Secondary outcomes include the feasibility, acceptability and cost-effectiveness of the intervention.

The study comprises three Work Packages:

Work Package 1 will be the single-arm, multi-centre feasibility study. The outcome will be the completion of a bowel cancer screening kit, providing preliminary evidence of efficacy.

Work Package 2 will evaluate feasibility from the service provider perspective, using surveys (Workstream 2a) and interviews (Workstream 2b) with AAA service providers.

Work Package 3 will assess acceptability from the service user perspective, using surveys (Workstream 3a) and interviews (Workstream 3b) with those who received the intervention during the study period.

The findings will be used to inform an implementation toolkit as part of a national strategy to improve the uptake of bowel screening.

Inclusion criteria

• Men aged 65 years and above
• Attending an AAA screening appointment
• Have not completed their most recent bowel screening
• Agree to discuss bowel screening further

Exclusion criteria

• Men aged <65years
• Those who do not attend their AAA screening appointment
• Have completed their most recent bowel screening
• Do not agree to discuss bowel screening further
• Those who received a positive AAA result in their appointment.