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Effectiveness of Interventions to Increase Cancer Screening

The Community Preventive Services Task Force published updated findings on the effectiveness of nine interventions aimed at increasing screening for breast, cervical, and colorectal cancers for the Guide to Community Preventive Services (The Community Guide). These findings are useful to clinical and public health care professionals and organizations interested in encouraging people to get screened for cancer.

The strength of evidence was increased from “insufficient evidence” to “sufficient evidence” for group education to increase mammography screening and for one-on-one education to increase screening with fecal occult blood testing (FOBT). The strength of evidence was upgraded from “sufficient” to “strong” for client reminders to increase FOBT screening. The strength of evidence for the other six interventions stayed the same (client incentives, mass media, reducing structural barriers to screening, reducing out-of-pocket costs for screening, provider assessment and feedback, and provider incentives).

Group Education

Group education encourages group members to get screened for cancer by explaining the benefıts of screening and ways to overcome barriers to screening. Health professionals or trained lay people can give group education to a variety of groups in different settings, using lectures, role modeling, teaching aids, and other styles.

There is now suffıcient evidence that group education increases breast cancer screening with mammography, but there is not enough evidence to know if it increases cervical or colorectal cancer screening.

One-on-One Education

In one-on-one education, a health professional, lay health advisor, or volunteer explains the benefıts of screening and ways to overcome barriers to screening to one person by telephone or in person. One-on-one education can take place in a medical office, community setting, workplace, or home. The message can be generic or tailored to the recipient’s characteristics, beliefs, or barriers to screening.

There is strong evidence that one-on-one education increases breast and cervical cancer screening, and suffıcient evidence that it increases colorectal cancer screening with FOBT. But there is not enough evidence to know if it increases colorectal cancer screening with other tests.

Client Reminders

Client reminders are text (letter, postcard, or e-mail) or telephone messages reminding people that their screening is due. Client reminders may be enhanced by follow-up printed or telephone reminders; information about the benefıts of screening and ways to overcome barriers to screening; and help in scheduling appointments. Reminders and recalls can be generic or tailored for one person.

There is strong evidence that client reminders increase screening for breast and cervical cancers, and for colorectal cancer with FOBT. But there is not enough evidence to know if it increases colorectal cancer screening with other tests.

Citation

Sabatino SA, Lawrence B, Elder R, Mercer SL, Wilson KM, DeVinney B, Melillo S, Carvalho M, Taplin S, Bastani R, Rimer BK, Vernon SW, Melvin CL, Taylor V, Fernandez M, Glanz K, Community Preventive Services Task Force. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the Guide to Community Preventive Services. American Journal of Preventive Medicine. 2012;43(1):765-786.

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