Optimising colorectal cancer screening acceptance: a review

Area of Science:

• Public Health
• Preventive Medicine
• Health Services Research

Background:

• Colorectal cancer (CRC) screening acceptance remains a challenge, necessitating effective interventions.
• Understanding factors influencing screening uptake is crucial for improving public health outcomes.

Purpose of the Study:

• To review evidence on effective interventions for increasing colorectal cancer (CRC) screening acceptance.
• To identify and categorize interventions based on established health models and screening delivery systems.

Main Methods:

• Systematic literature search of randomized trials in major databases (PubMed, Embase, Cochrane).
• Exclusion of small studies and those predating large fecal occult blood test trials.
• Intervention categorization using Continuum of Cancer Care and PRECEDE-PROCEED models; grouping by opportunistic vs. organized screening.

Main Results:

• Multifactor interventions targeting multiple care levels are most effective for CRC screening acceptance.
• Removing financial barriers, systematic population contact, personal invitations, and reminders enhance screening uptake.
• Organized screening programs achieve extensive coverage, improve equity, maximize health impact, and offer better cost-effectiveness.

Conclusions:

• Comprehensive, multifactor interventions are key to boosting colorectal cancer screening acceptance.
• Organized screening programs are superior for broad reach, equity, and cost-effective health impact.
• Combining individual-level education with organizational strategies optimizes screening program effectiveness.