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Cancer > Cancer Screening > Improving the Use of Screening
Improving the Use of Breast, Cervical and Colorectal Cancer Screening
Screening procedures are effective in detecting breast, cervical, and colorectal cancer at early stages and, combined with appropriate treatment, are likely to reduce mortality. The United States Preventive Services Task Force (USPSTF) recommends regular breast, cervical, and colorectal cancer screening. The Guide to Community Preventive Services identifies population-based and health system-based interventions that are effective in promoting increased use of breast, cervical, and colorectal cancer screening. The goal is to help practitioners, policy makers, researchers, and research funders identify effective strategies for increasing screening and to highlight gaps in the research where additional questions need to be answered.
Summary of Findings
The independent Task Force on Community Preventive Services examined the effectiveness of two broad categories of interventions:
- client-based interventions, and
- provider-oriented interventions.
Within the category of client-based interventions, they studied interventions that aim to:
- increase community demand for screening, or
- increase community access to screening.
The Task Force considered client-based interventions separately for the three cancer sites (breast, cervical, and colorectal) because the clients for each of these screening tests can be very different. The Task Force considered provider-oriented interventions across all three sites, however, because providers might be influenced by similar factors when deciding whether to recommend screening for their various clients.
The following table lists current Task Force findings specific to interventions for increasing breast, cervical, and colorectal screening. The Task Force based these recommendations on their assessment of the strength of published evidence as to whether these interventions are effective. The evidence they examined resulted from systematic reviews of scientific articles that was conducted for the Task Force by a team of scientists and other experts.
A finding of “insufficient evidence to determine effectiveness” does NOT mean that the intervention doesn’t work, but, rather, that additional research is needed to determine whether or not the intervention is effective.
Task Force Findings for Cancer Screening Interventions
Client-based Interventions |
| Community Demand |
Breast |
Cervical |
Colorectal |
| Client reminder |
Recommended |
Recommended |
Recommended |
| Client incentive |
Insufficient Evidence |
Insufficient Evidence |
Insufficient Evidence |
| Mass media |
Insufficient Evidence |
Insufficient Evidence |
Insufficient Evidence |
| Small media |
Recommended |
Recommended |
Recommended |
| Group education |
Insufficient Evidence |
Insufficient Evidence |
Insufficient Evidence |
| One-on-one education |
Recommended |
Recommended |
Insufficient Evidence |
| Community Access |
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| Reducing structural barrier |
Recommended |
Insufficient Evidence |
Recommended |
| Reducing out-of-pocket expense |
Recommended |
Insufficient Evidence |
Insufficient Evidence |
Provider-oriented Interventions |
| Provider reminder |
Recommended |
| Provider assessment and feedback |
Recommended |
| Provider incentive |
Insufficient Evidence |
Multicomponent Interventions |
| Multicomponent interventions |
Recommended |
How to Use These Findings
- The Community Guide identifies interventions to increase cancer screening that have been recommended by the Task Force based on evidence of effectiveness. The Community Guide Web site also links to Cancer Control P.L.A.N.E.T. This National Cancer Institute Web site provides examples of programs that use these effective interventions along with related “how to” materials. Public health program planning tools may also be helpful in determining how these evidence-based recommendations fit with your local needs, goals, and constraints.
- Researchers, as well as those who fund research, can benefit from the research gaps identified in each review as important areas for additional study. These gaps may include interventions for which there is insufficient evidence of effectiveness to date, or groups for whom effectiveness of the intervention has not been adequately studied. Cancer Control P.L.A.N.E.T. can also help you locate others who might be interested in conducting such research.
The Guide to Community Preventive Services is an ever-expanding resource for recommendations on evidence-based interventions to improve public health, including preventing and controlling diseases, injuries, and other health-related conditions. For more information about the Community Guide (including links to publications and a variety of resources) see
www.thecommunityguide.org and for more information about the cancer reviews, visit
www.thecommunityguide.org/cancer/.
This information is in the public domain. Copying and disseminating freely is encouraged. However, citation to source is appreciated.
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