4.7 Review

What Multilevel Interventions Do We Need to Increase the Colorectal Cancer Screening Rate to 80%?

Journal

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Volume 19, Issue 4, Pages 633-645

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2019.12.016

Keywords

Mass Screening; Colorectal Cancer; Healthcare Disparities; Implementation Science

Funding

  1. NIH [K24 DK080941]

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Various interventions have been studied for their effectiveness in increasing colorectal cancer screening uptake, including outreach, navigation, patient education, provider education, reminders, financial incentives, and individual preference, with the choice of screening strategies showing higher adherence.
Screening reduces colorectal cancer mortality; however, this remains the second leading cause of cancer deaths in the United States and adherence to colorectal cancer screening falls far short of the National Colorectal Cancer Roundtable goal of 80%. Numerous studies have examined the effectiveness of interventions to increase colorectal cancer screening uptake. Outreach is the active dissemination of screening outside of the primary care setting, such as mailing fecal blood tests to individuals' homes. Navigation uses trained personnel to assist individuals through the screening process. Patient education may take the form of brochures, videos, or websites. Provider education can include feedback about screening rates of patient panels. Reminders to healthcare providers can be provided by dashboards of patients due for screening. Financial incentives provide monetary compensation to individuals when they complete screening tests, either as fixed payments or via a lottery. Individual preference for specific screening strategies has also been examined in several trials, with a choice of screening strategies yielding higher adherence than recommendation of a single strategy.

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