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

Abstract

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.

Operationalizing a Rideshare Intervention for Colonoscopy Completion: Barriers, Facilitators, and Process Recommendations

“…To improve CRC screening through initial and follow-up colonoscopy completion, multi-component interventions are needed (34). Our prior work and other published research have identified multiple barriers and facilitators to colonoscopy completion at the patient, provider, and health-system level for which there are practical solutions (17,35,36).…”

Colorectal cancer surveillance by colonoscopy in a prospective, population-based long-term Swiss screening study – outcomes, adherence, and costs

“…Surveillance with a second colonoscopy screening in low-risk individuals could be replaced by surveillance with the more affordable screening method using a quantitative fecal immunochemical blood test (FIT) every one to two years. Evidence indicates that the use of FIT at screening has better acceptance and detects many cancers early 16 20 48 49 50 51 . The stool test should at least be offered to low-risk individuals as an additional choice for colonoscopy.…”

Dickdarmkrebsscreening in der Schweiz: Sind unsere Patienten genügend motiviert?

“…Leider wird aber nicht selten nicht einmal jeder zweite positive FIT abgeklärt [18,19]. Viele Personen haben den Sinn von FIT nicht richtig verstanden oder fürchten sich vor der Endoskopie und deren Resultat [20,21]. Würde bei der Mitteilung des Testresultats gleich ein im Voraus fixierter Termin für die Koloskopie angeboten, könnte die Abklärungsrate wesentlich verbessert werden [22][23][24], wie dies bei der Mammographie, beim Zervixabstrich und der Sigmoidoskopie gezeigt wurde.…”