Strategies for increasing participation in mail-out colorectal cancer screening programs: a systematic review and meta-analysis

Goodwin, Belinda C. and Ireland, Michael J. and March, Sonja and Myers, Larry and Crawford-Williams, Fiona and Chambers, Suzanne K. and Aitken, Joanne F. and Dunn, Jeff (2019) Strategies for increasing participation in mail-out colorectal cancer screening programs: a systematic review and meta-analysis. Systematic Reviews, 8 (257). pp. 1-11.

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Abstract

Background: Population mail-out bowel screening programs are a convenient, cost-effective and sensitive method of detecting colorectal cancer (CRC). Despite the increased survival rates associated with early detection of CRC, in many countries, 50% or more of eligible individuals do not participate in such programs. The current study systematically reviews interventions applied to increase fecal occult blood test (FOBT) kit return, specifically in population mail-out programs.

Methods: Five electronic databases (PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertations and Theses) were searched for articles published before 10th of March 2018. Studies were included if they reported the results of an intervention designed to increase the return rate of FOBT kits that had been mailed to individuals’ homes. PRISMA systematic review reporting methods were applied and each study was assessed using Cochrane’s Risk of Bias tool. Pooled effect sizes were calculated for each intervention type and risk of bias was tested as a moderator for sensitivity analysis.

Results: The review identified 53 interventions from 30 published studies from which nine distinct intervention strategy types emerged. Sensitivity analysis showed that risk of bias marginally moderated the overall effect size. Pooled risk ratios and confidence intervals for each intervention type revealed that telephone contact (RR = 1.23, 95%CI (1.08 – 1.40)), GP endorsement (RR = 1.19, 95%CI (1.10 – 1.29)), simplified test procedures (RR = 1.17, 95%CI (1.09 – 1.25)), and advance notifications (RR = 1.09, 95%CI (1.07 – 1.11)) were effective intervention strategies with small to moderate effect sizes. Studies with a high risk of bias were removed and pooled effects remained relatively unchanged

Conclusions: Interventions that combine program-level changes incorporating the issue of advance notification and alternative screening tools with the involvement of primary health professionals through endorsement letters and telephone contact should lead to increases in kit return in mail-out CRC screening programs.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Files associated with this item cannot be displayed due to copyright restrictions.
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling (1 Jan 2015 -)
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling (1 Jan 2015 -)
Date Deposited: 20 Jan 2020 06:42
Last Modified: 05 Feb 2020 06:08
Uncontrolled Keywords: Fecal occult blood test; colorectal cancer screening; bowel cancer screening; population screening; intervention; systematic review, meta-analysis
Fields of Research : 11 Medical and Health Sciences > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified
17 Psychology and Cognitive Sciences > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
Identification Number or DOI: 10.1186/s13643-019-1170-x
URI: http://eprints.usq.edu.au/id/eprint/37086

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