Increasing Cancer Screening: Provider Assessment and Feedback
Provider assessment and feedback interventions both evaluate provider performance in delivering or offering screening to clients (assessment) and present providers with information about their performance in providing screening services (feedback). Feedback may describe the performance of a group of providers (e.g., mean performance for a practice) or an individual provider, and may be compared with a goal or standard.
Summary of Task Force Recommendations and Findings
The Community Preventive Services Task Force recommends provider assessment and feedback interventions on the basis of sufficient evidence of effectiveness in increasing screening for breast cancer (mammography), cervical cancer (Pap test), and colorectal cancer (FOBT).
Evidence was insufficient, however, to determine the effectiveness of this intervention in increasing colorectal cancer screening using methods other than FOBT.
Results from the Systematic Reviews
The Task Force findings are based on evidence from a previously completed review (search period 1966-2004) and an updated review (search period 2004-2008). Updates of reviews are conducted to incorporate more recent evidence.
This review included nine studies.
- Screening for breast, cervical or colorectal cancer: median increase of 13.0 percentage points (interquartile interval [IQI]: 11.5 to 30.5 percentage points).
- Completed breast cancer screening by mammography: estimated effects ranged from a 3.4 to 20.6 percentage point increase (4 study arms)
- Completed cervical screening by Pap test: estimated effects ranged from a 4.0 to 29.5 percentage point increase (4 study arms)
- Completed colorectal screening by fecal occult blood test (FOBT): estimated effects ranged from a 12.3 to 23.0 percentage point increase (3 study arms)
The recommendation to increase screening for breast and cervical cancer as well as colorectal cancer (through FOBT) should be applicable across various settings and provider training status may be related to magnitude of effect.
These findings were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to cancer prevention and control.
The updated search for evidence included one study specific to colorectal cancer screening. Monetary values are presented in 2009 U.S dollars.
- The estimated cost of increasing screening for colorectal cancer among military veterans was $1,074 per additional screening.
- Analytic Framework – see Figure 3 on page 101 [PDF - 230 kB]
- Summary Evidence Table - Effectiveness Review [PDF - 208 kB]
- Summary Evidence Table - Economic Review [PDF - 73 kB]
- Included Studies - Economic Review
- Search Strategy
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. [PDF - 235 kB] Am J Prev Med 2012;43(1):765-86.
Community Preventive Services Task Force. Updated recommendations for client- and provider-oriented interventions to increase breast, cervical, and colorectal cancer screening. [PDF - 90 kB]. Am J Prev Med 2012;43(1):760-4.
Read other Community Guide publications about Cancer Prevention and Control in our library.
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Increasing cancer screening: provider assessment and feedback. www.thecommunityguide.org/cancer/screening/provider-oriented/assessment.html. Last updated: MM/DD/YYYY.
Review completed: October 2009
- Page last reviewed: April 19, 2016, 2016
- Page last updated: April 19, 2016
- Content source: The Guide to Community Preventive Services