According to a systematic review published in the journal Preventive Medicine, multi-level interventions for the faecal immunochemical test (FIT) based colorectal cancer (CRC) screening programme could significantly improve screening participation.
Researchers conducted a systematic review of 25 studies (23 randomised controlled trials, 1 quasi-experimental and 1 observational study) identified through a literature search on electronic databases between 1996 and 2017. These included mailed FIT outreach (10 studies), pre-FIT patient reminders (4 studies), tailored patient messages (3 studies), post-FIT reminders (2 studies), paired FIT with influenza vaccinations (2 studies), provider alerts (2 studies) and studies describing the use of high-quality small media (1 study) and patient financial incentives (1 study).
The median efficacy of mailed FIT outreach in improving CRC screening was 21.5% (interquartile range [IQR], 13.6%-29.0%). FIT paired with vaccinations led to a median improvement of 15.9% (IQR, 15.6%-16.3%). Pre-FIT and post-FIT reminders demonstrated modest efficacy with a median improvement in CRC screening of 4.1% (IQR, 3.6%-6.7%) and 3.1% (IQR, 2.9%-3.3%), respectively.
The authors said: "Considering infrastructural issues, effective interventions, mostly custom made based on prior screening behaviours with enhanced use of electronic health records should be implemented as widely as possible to track patients. Altogether, these strategies have the potential to improve CRC screening participation rapidly and reduce downstream discriminations in health care results beyond any particular intervention."
