Open Access Study protocol

Anticipated regret to increase uptake of colorectal cancer screening in Scotland (ARTICS): study protocol for a randomised controlled trial

Ronan E O’Carroll1*, Robert JC Steele2, Gillian Libby3, Linda Brownlee3 and Julie A Chambers1

Author Affiliations

1 Psychology, School of Natural Sciences, Stirling University, Stirling FK9 4LA, UK

2 Surgery and Molecular Oncology, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK

3 Scottish Bowel Screening Centre, Kings Cross Hospital, Clepington Rd, Dundee DD3 8EA, UK

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BMC Public Health 2013, 13:849  doi:10.1186/1471-2458-13-849

Published: 16 September 2013



Colorectal cancer is the second leading cause of cancer deaths in the UK. Screening is key to early detection. The Scottish programme of colorectal cancer screening is running successfully, and involves all adults aged between 50 and 74 years being invited to post back a faecal sample for testing every 2 years. However, screening uptake is sub-optimal: for example rates for the period November 2009 to October 2011 ranged from just 39% for males living in the most deprived areas to 67% for least deprived females. Recent research has shown that asking people to consider the emotional consequences of not participating in screening (anticipated regret) can lead to a significant increase in screening uptake.


We will test a simple anticipated regret manipulation, in a large randomised controlled trial with 60,000 members of the general public. They will be randomly allocated to one of 3 arms, no questionnaire, control questionnaire or anticipated regret questionnaire. The primary outcome will be screening test kit return. Results will also be examined by demographic variables (age, gender, deprivation) as these are currently related to screening kit return.


If this anticipated regret intervention leads to a significant increase in colorectal cancer screening kit returns, this would represent a rare example of a theoretically-driven, simple intervention that could result in earlier detection of colorectal cancer and many more lives saved.

Trial registration

Current Controlled trials: ISRCTN74986452

Colorectal cancer; Screening; Anticipated regret; Health locus of control; ‘Ick’ factor