Nudging to increase the uptake of cancer screening: scoping review of empirical studies

Cancer screening is critical for early detection of cancer, yet achieving high participation rates remains a substantial challenge. This study aims to examine empirically tested nudging interventions and their effects on increasing cancer screening uptake.

A scoping review was conducted following PRISMA-ScR guidelines. Empirical studies on nudging to enhance cancer screening uptake, published from January 2008 to August 2025, were retrieved from Scopus, Web of Science, Science Direct, and EBSCO (including Academic Search Complete, Health Source: Nursing/Academic Edition, and MEDLINE) databases/search platforms. A complementary risk of bias analysis was performed for the selected studies.

Fifteen articles were included in this review. Most studies were carried out in real-life settings, with health system providers or professionals delivering nudges. The most common nudging techniques involved reminders combined with information provision. Results varied widely, ranging from no statistically significant effect to increases of several tens of percentage points, with a maximum increase of 65.1 percentage points. Randomised controlled trials with acceptable risk of bias demonstrated diverse outcomes, while other studies lacking a controlled approach reported positive results. Interventions that modified decision structures-such as altering options, adjusting consequences, or reducing effort-were the most effective and produced the largest increases. Intervention effects tended to be higher when resource-demanding components were included and/or healthcare professionals were involved.

The review indicates that nudge interventions can positively influence cancer screening uptake. Further research is needed to explore various nudging strategies across diverse settings, particularly through rigorous randomised controlled trials.