BESTcc study

Type of project: Regional  |  Start date: 21/07/2020  |  End date: 20/07/2024

Colorectal cancer (CRC) is a major health problem in Europe, which is accompanied by intensive screening activities. A new communication strategy, based on the concepts of behavioural economics (BE), has recently been proposed for use in screening. BE is intended both to suggest novel perspectives on the lifestyle of the population and to provide new methods for improving participation in screening. Therefore, the idea of drafting screening invitation letters based on this new approach is certainly interesting.

The aim of this project is to evaluate the impact of different invitation strategies on the rate of participation in colorectal screening. For this purpose, a total of 84,600 people of both sexes, aged 54-70 years and non-responders to screening, will be randomised into six study arms. The project will be conducted within the territory of the three Tuscan Local Health Units.

The laboratory ItaliaNLP Lab of the Cnr-Istituto di Linguistica Computazionale “Antonio Zampolli” will be responsible for analysing the lexicon of the various letters used in the study to identify whether there are elements of linguistic complexity. The analysis will be conducted with READ-IT, a readability assessment tool based on advanced Natural Language Processing techniques and machine learning algorithms. In this phase, READ-IT will be specialised, i.e. retrained on specialised medical documents.

The automatic identification of vocabulary and syntactic structures could in the future support physicians to rewrite invitation letters making them linguistically more comprehensible for users. The results of this phase will be compared with the results of a questionnaire that will be mailed to users already invited to screening in 2021 and to users who test positive for faecal occult blood and come to ISPRO for an in-depth colonoscopy. Those who agree to complete the questionnaire will assess the lexical complexity of text extracts from the invitation letters. The questionnaire will be completed online in a totally anonymous manner.