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Participation rates in colorectal cancer screening in Germany are low. We therefore investigated the effectiveness of different invitation models for immunological stool blood tests (fecal immunological tests, FITs). A randomized controlled trial in 50- to 54-year-old clients of the health insurance provider AOK Baden-Wuerttemberg. A total of 17 532 insured persons were randomized to receive (A) an invitation letter including a FIT (n = 585; ( an invitation letter including an option to request a FIT (n = 5844); or (C) an invitation letter only