Theme: Guide to community preventive service
Effectiveness of Interventions to Increase Screening for Breast, Cervical, and Colorectal Cancers: Nine Updated Systematic Reviews for the Guide to Community Preventive Services

https://doi.org/10.1016/j.amepre.2012.04.009Get rights and content

Context

Screening reduces mortality from breast, cervical, and colorectal cancers. The Guide to Community Preventive Services previously conducted systematic reviews on the effectiveness of 11 interventions to increase screening for these cancers. This article presents results of updated systematic reviews for nine of these interventions.

Evidence acquisition

Five databases were searched for studies published during January 2004–October 2008. Studies had to (1) be a primary investigation of one or more intervention category; (2) be conducted in a country with a high-income economy; (3) provide information on at least one cancer screening outcome of interest; and (4) include screening use prior to intervention implementation or a concurrent group unexposed to the intervention category of interest. Forty-five studies were included in the reviews.

Evidence synthesis

Recommendations were added for one-on-one education to increase screening with fecal occult blood testing (FOBT) and group education to increase mammography screening. Strength of evidence for client reminder interventions to increase FOBT screening was upgraded from sufficient to strong. Previous findings and recommendations for reducing out-of-pocket costs (breast cancer screening); provider assessment and feedback (breast, cervical, and FOBT screening); one-on-one education and client reminders (breast and cervical cancer screening); and reducing structural barriers (breast cancer and FOBT screening) were reaffirmed or unchanged. Evidence remains insufficient to determine effectiveness for the remaining screening tests and intervention categories.

Conclusions

Findings indicate new and reaffirmed interventions effective in promoting recommended cancer screening, including colorectal cancer screening. Findings can be used in community and healthcare settings to promote recommended care. Important research gaps also are described.

Section snippets

Context

Cancer is the second-leading cause of death in the U.S.1 According to U.S. Cancer Statistics,2 more than 560,000 people died from cancer in 2007. Screening reduces cancer mortality, and in some cases, incidence from breast, cervical, and colorectal cancers.3, 4, 5 The U.S. Preventive Services Task Force recommends age-appropriate screening for breast cancer with mammography; cervical cancer with Pap tests; and colorectal cancers with fecal occult blood test (FOBT), flexible sigmoidoscopy, or

Evidence Acquisition

Methods for conducting the original Community Guide systematic reviews of interventions to increase breast, cervical, and colorectal cancer screening are described elsewhere.21 These methods were followed for the current updates with the exception of adaptations described in this section.

Analytic frameworks for the three primary strategies assessed through updated reviews are shown in Figure 1, Figure 2, Figure 3. These frameworks are unchanged from those used in the original reviews with the

Definition

Group education conveys information about indications for, benefits of, and ways to overcome barriers to screening with goals of informing, encouraging, and motivating participants to seek recommended screening. Group education usually is conducted by health professionals or by trained lay people who use presentations or other teaching aids in lectures or interactive formats; they often incorporate role modeling or other methods. Group education can be given to a variety of groups, in different

Discussion

These reviews update the evidence base underlying Task Force recommendations for nine interventions to increase community demand, enhance community access, and increase provider delivery of recommended cancer screening services. Recommendations were expanded to include interventions using one-on-one education to increase colorectal cancer screening with FOBT and group education to increase mammography screening. Further, the Task Force upgraded the strength of evidence for client reminder

References (140)

  • V. Champion et al.

    The effect of telephone versus print tailoring for mammography adherence

    Patient Educ Couns

    (2007)
  • J.R. Bloom et al.

    Effects of a telephone counseling intervention on sisters of young women with breast cancer

    Prev Med

    (2006)
  • D.A. Abood et al.

    Loss-framed minimal intervention increases mammography use

    Womens Health Issues

    (2005)
  • V. Champion et al.

    Comparison of tailored interventions to increase mammography screening in nonadherent older women

    Prev Med

    (2003)
  • M.E. Costanza et al.

    Promoting mammography: results of a randomized trial of telephone counseling and a medical practice intervention

    Am J Prev Med

    (2000)
  • L.A. Crane et al.

    Cancer Information Service-initiated outcalls to promote screening mammography among low-income and minority women: design and feasibility testing

    Prev Med

    (1998)
  • I.M. Lipkus et al.

    Can tailored interventions increase mammography use among HMO women?

    Am J Prev Med

    (2000)
  • B.K. Rimer et al.

    Effects of a mammography decision-making intervention at 12 and 24 months

    Am J Prev Med

    (2002)
  • B.G. Valanis et al.

    Screening HMO women overdue for both mammograms and Pap tests

    Prev Med

    (2002)
  • J.M. Segura et al.

    A randomized controlled trial comparing three invitation strategies in a breast cancer screening program

    Prev Med

    (2001)
  • J.F.C. Sung et al.

    Effect of a cancer screening intervention conducted by lay health workers among inner-city women

    Am J Prev Med

    (1997)
  • E.E. Calle et al.

    Personal contact from friends to increase mammography usage

    Am J Prev Med

    (1994)
  • B.K. Rimer et al.

    The impact of tailored interventions on a community health center population

    Patient Educ Couns

    (1999)
  • M.E. Costanza et al.

    Using tailored telephone counseling to accelerate the adoption of colorectal cancer screening

    Cancer Detect Prev

    (2007)
  • M.R. Partin et al.

    Randomized controlled trial of a repeat mammography intervention: effect of adherence definitions on results

    Prev Med

    (2005)
  • M.T. Ruffin et al.

    Interventions fail to increase cancer screening rates in community-based primary care practices

    Prev Med

    (2004)
  • D.M. Becker et al.

    Improving preventive care at a medical clinic: how can the patient help?

    Am J Prev Med

    (1989)
  • S. Morrell et al.

    How much does a reminder letter increase cervical screening among under-screened women in NSW?

    Aust N Z J Public Health

    (2005)
  • J.Q. Xu et al.

    Deaths: final data for 2007

    Natl Vital Stat Rep

    (2010)
  • U.S. Cancer Statistics: 1999–2007 incidence and mortality web-based report

  • Screening for cervical cancer, topic page

  • Screening for colorectal cancer, topic page

  • Screening for breast cancer, topic page

  • Health, U.S. 2009: with special feature on medical technology

    (2010)
  • C.N. Klabunde et al.

    Trends in colorectal cancer test use among vulnerable populations in the U.S.

    Cancer Epidemiol Biomarkers Prev

    (2011)
  • D.J. Holden et al.

    Enhancing the use and quality of colorectal cancer screening, evidence report/technology assessment no. 190

    (2010)
  • Vital signs: colorectal cancer screening, incidence, and mortality—U.S., 2002–2010

    MMWR Morb Mortal Wkly Rep

    (2011)
  • Cancer screening—U.S., 2010

    MMWR Morb Mortal Wkly Rep

    (2012)
  • W. Rakowski et al.

    Correlates of repeat and recent mammography for women ages 45 to 75 in the 2002 to 2003 Health Information National Trends Survey (HINTS 2003)

    Cancer Epidemiol Biomarkers Prev

    (2006)
  • J. Swan et al.

    Data and trends in cancer screening in the United States: Results from the 2005 National Health Interview Survey

    Cancer

    (2010)
  • S.A. Sabatino et al.

    Disparities in mammography use among U.S. women aged 40–64 years, by race, ethnicity, income, and health insurance status

    Med Care

    (2008)
  • E. Ward et al.

    Association of insurance with cancer care utilization and outcomes

    CA Cancer J Clin

    (2008)
  • Methods used for reviewing evidence and linking evidence to recommendations

  • L.S. Aiken et al.

    Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program

    Health Psychol

    (1994)
  • E. King et al.

    Strategies to encourage mammography use among women in senior citizens' housing facilities

    J Cancer Educ

    (1998)
  • S.I. Mishra et al.

    Improving breast cancer control among Latinas: evaluation of a theory-based educational program

    Health Educ Behav

    (1998)
  • C.S. Skinner et al.

    Outcomes of the Learn, Share & Live breast cancer education program for older urban women

    Am J Public Health

    (2000)
  • D.J. Bowen et al.

    Effects of breast cancer risk counseling for sexual minority women

    Health Care Women Int

    (2006)
  • D.E. Hurdle

    Breast cancer prevention with older women: a gender-focused intervention study

    Health Care Women Int

    (2007)
  • V.A. Lopez et al.

    Participation and program outcomes in a church-based cancer prevention program for Hispanic women

    J Community Health

    (2006)
  • Cited by (366)

    • Lack of Awareness of Human Papillomavirus Testing Among U.S. Women

      2023, American Journal of Preventive Medicine
    View all citing articles on Scopus

    Dr. Wilson was affiliated with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, and Dr. Melvin was affiliated with The University of North Carolina at Chapel Hill when this research was completed.

    Names and affiliations of Task Force members are available at www.thecommunityguide.org/about/task-force-members.html.

    View full text