On SAGE Insight: Evaluation of interventions to improve participation in cancer screening services

Article title: Rapid review of evaluation of interventions to improve participation in cancer screening services

From Journal of Medical Screening

Screening participation is spread differently across populations, according to factors such as ethnicity or socioeconomic status. This paper reviews the current evidence on effects of interventions to improve cancer screening participation, focusing in particular on effects in underserved populations.

While it is agreed that decisions to participate in cancer screening should be free from undue pressure, and should be well-informed, it is also frequently observed that there are considerable inequalities in participation in cancer screening.  United Kingdom (UK), screening participation rates are lower in areas of deprivation and among certain ethnic groups. There is a wide range of potential interventions to improve access to cancer screening services and, therefore, increase participation.

To inform policy and practice, a review should identify those measures most and least likely to be effective, including any findings with respect to inequalities, or effects of interventions in deprived or otherwise underserved populations.

Across different countries and health systems, a number of interventions were found more consistently to improve participation in cancer screening, including in underserved populations: pre-screening reminders, general practitioner endorsement, more personalized reminders for non-participants, and more acceptable screening tests in bowel and cervical screening.


Abstract

Objective
Screening participation is spread differently across populations, according to factors such as ethnicity or socioeconomic status. We here review the current evidence on effects of interventions to improve cancer screening participation, focussing in particular on effects in underserved populations.
Methods
We selected studies to review based on their characteristics: focussing on population screening programs, showing a quantitative estimate of the effect of the intervention, and published since 1990. To determine eligibility for our purposes, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search and expanded this until the search yielded eligible papers on title review which were less than 1% of the total. We classified the eligible studies by intervention type and by the cancer for which they screened, while looking to identify effects in any inequality dimension.
Results
The 68 papers included in our review reported on 71 intervention studies. Of the interventions, 58 had significant positive effects on increasing participation, with increase rates of the order of 2%–20% (in absolute terms).
Conclusions
Across different countries and health systems, a number of interventions were found more consistently to improve participation in cancer screening, including in underserved populations: pre-screening reminders, general practitioner endorsement, more personalized reminders for non-participants, and more acceptable screening tests in bowel and cervical screening.

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Article details
Rapid review of evaluation of interventions to improve participation in cancer screening services
Journal of Medical Screening
July 2016
DOI: 10.1177/0969141316664757

 

     
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