# Send screening invitations with a pre-booked time, not a request to call

Source: https://onco.cc/ideas/idea-prev-screening-default-appointments/  
OnCo record `idea-prev-screening-default-appointments` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Uptake rises when the invitation comes with a booked appointment and text reminders. Make that the default in every screening programme.

## Summary

Uptake rises when a screening invitation arrives with a booked appointment and text reminders, so this idea makes that the national standard: every invitation carries a default booked slot with easy rebooking, a GP-endorsed letter and two SMS reminders. Timed appointments, reminders and GP endorsement each raise uptake in randomised trials in UK breast and bowel screening, and behavioural defaults are well understood. The aim is higher uptake overall and especially in the most deprived quintile. The test is programme-level A/B testing at scale, feasible in most call and recall systems. Being tested at scale, it addresses the bottleneck Prevention we already have is not deployed and is linked from the NordICC paper.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Default slots plus reminders raise uptake by at least 8 percentage points overall and 12 points in the most deprived quintile.
- Rationale: Behavioural defaults; multiple randomised trials in UK breast and bowel screening.
- Proposed test: Programme-level A/B testing at scale, feasible in most call/recall systems.
- Maturity: being-tested-at-scale
- Actor: policy

## Sources

- Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018): https://doi.org/10.3322/caac.21440

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Prevention & Risk](https://onco.cc/fronts/prevention/)
- bottlenecks: [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- key papers: [NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected](https://onco.cc/key-papers/paper-nordicc-nejm-2022/), [Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States](https://onco.cc/key-papers/paper-islami-ca-cancer-j-clin/)
- ideas: [Decide who is screened for lung cancer by individual risk, not by pack-years](https://onco.cc/ideas/idea-lung-screening-eligibility-by-risk-not-pack-years/)

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