Increasing Cancer Screening: Provider Incentives
Provider incentives are direct or indirect rewards intended to motivate providers to perform cancer screening or make appropriate referral for their patients to receive these services. Rewards are often monetary, but can also include nonmonetary incentives (e.g., continuing medical education credit). Because some form of assessment is needed to determine whether providers receive rewards, an assessment component may be included in the intervention.
Summary of Task Force Recommendations and Findings
The Community Preventive Services Task Force finds insufficient evidence to determine the effectiveness of provider incentives in increasing screening for breast, cervical or colorectal cancers. Evidence is insufficient because of a small magnitude of effect across studies and because data from health care systems that include provider incentives as part of their strategies for administration and provider compensation have not been published.
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.
The review included 5 studies.
- Screening completion for breast, cervical or colorectal cancer: median increase of 1.7 percentage points (interquartile interval [IQI]: -0.1 to 3.6 percentage points; 7 study arms)
- Completed breast cancer screening by mamography: estimated effects ranged from a 2.0 decrease to a 1.7 percentage point increase (2 study arms)
- Completed cervical cancer screening by Pap test: estimated effects ranged from a 3.6 to 8.0 percentage point increase (2 study arms)
- Completed colorectal cancer screening: estimated effects ranged from a 0.1 decrease to a 2.8 percentage point increase ( 2 study arms)
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.
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.
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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 incentives. www.thecommunityguide.org/cancer/screening/provider-oriented/incentives.html. Last updated: MM/DD/YYYY.
Review completed: October 2009
- Page last reviewed: September 24, 2013
- Page last updated: September 24, 2013
- Content source: The Guide to Community Preventive Services