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Cancer > Cancer Screening > Small Media
Client-oriented Cancer Screening Interventions:
Small Media
On behalf of the Task Force on Community Preventive Services, a team of subject matter specialists and other scientists conducted a systematic review of published studies evaluating the effectiveness of small media in increasing screening for breast, cervical and colorectal cancer.
The Task Force recommends interventions that use small media based on evidence of their effectiveness in increasing:
- breast cancer screening by mammography
- cervical cancer screening by Pap test, and
- colorectal cancer screening by fecal occult blood testing (FOBT).
The Task Force concluded there was insufficient evidence to determine the effectiveness of using small media to increase:
- colorectal cancer screening by flexible sigmoidoscopy, colonoscopy, or double contrast barium enema.
- Small media interventions are defined as videos or printed communications (such as letters, brochures, leaflets, pamphlets, flyers, or newsletters) that:
- are distributed from healthcare systems or other community settings, and
- convey educational or motivational information to promote cancer screening in target populations.
- Small media interventions may contain messages that can:
- describe screening tests and procedures,
- provide reasons for and benefits of screening, and
- suggest ways to overcome barriers to screening.
- Small media messages can:
- address a general target population (untailored messages), or
- address unique circumstances and characteristics of specific individuals that are identified through individual assessments (tailored messages).
Breast Cancer: Small Media are Recommended to Increase Screening
Findings from the Systematic Review
- Nineteen studies qualified for the systematic review and included 23 outcome measures.
- There was a median increase of 7.0 percentage points in the proportion of study participants who completed breast cancer screening by mammography as the result of small media interventions.
- Small media interventions were effective when tailored (7.0 percentage point median increase) and when untailored (5.3 percentage point median increase).
- Reviewed studies were conducted in both rural and urban communities and among different racial, ethnic, and socioeconomic groups.
Cervical Cancer: Small Media are Recommended to Increase Screening
Findings from the Systematic Review
- Twelve studies qualified for the systematic review and included 15 effect measures.
- There was a median increase of 4.5 percentage points in the proportion of study participants who completed cervical cancer screening by Pap test as the result of small media interventions.
- The two studies that included tailored inventions showed that tailoring was either less effective or, at best, no more effective than untailored interventions.
- Questions remain about the value of tailoring small media interventions to increase cervical cancer screening rates.
- Reviewed studies were conducted in both rural and urban communities and among different racial, ethnic, and socioeconomic groups.
Colorectal Cancer: Small Media are Recommended to Increase Screening by FOBT; Does Not Apply to Other Screening Methods
Findings from the Systematic Review
- From seven studies that qualified for the systematic review (one included a tailored intervention), eight outcome measures demonstrated a 12.7 percentage point median increase in completed colorectal cancer screening by FOBT, as the result of small media interventions.
- Evidence is insufficient to determine whether the intervention is effective in increasing colorectal cancer screening by flexible sigmoidoscopy, colonoscopy, or double contrast barium enema, because no studies of these procedures qualified for the review.
- Reviewed studies were conducted among different racial, ethnic, and socioeconomic groups.
Prior to and during the literature review and data analysis, the review team and the Task Force on Community Preventive Services attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as “research gaps". Research gaps are pulled together in the form of a basic set of questions to inform a research agenda for those in the field. Each completed Community Guide review includes a section on research gaps (or issues) and this is included in final evidence review publications.
Cancer is a major public health problem in the United States. For more information on the scope of this problem, visit
Background on Screening for Breast, Cervical and Colorectal Cancers.
Evidence Review:
Baron RC, Rimer BK, Breslow RA, et al.
Client-directed interventions to increase community
demand for breast, cervical, and colorectal cancer
screening: a systematic review.
Am J Prev Med 2008;35(1S):34-55.
Recommendations:
Task Force on Community Preventive
Services. Recommendations for client- and
provider-directed interventions to increase
breast, cervical, and colorectal cancer screening
Am J Prev Med 2008;35(1S):21-5.
The findings and conclusions in this report are those of the authors and the Task Force on Community Preventive Services and do not necessarily represent the official position of the CDC.
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. Client-oriented cancer screening interventions: small media.
www.thecommunityguide.org/cancer/screening/small-media.htm.
Last Updated: MM/DD/YYYY.
Review completed: July 2008
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