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BACKGROUND Fecal occult blood testing has been offered for many years in the German health care system, but participation rates have been notoriously low. OBJECTIVE The aim of this study is to evaluate the effect of various personal invitation schemes on the use of fecal immunochemical tests (FITs) in persons aged 50-54 years. METHODS This study consists of a three-armed randomized controlled trial (1) arm A an invitation letter from a health insurance plan including a FIT test kit, (2) arm B an invitation letter f