Community Guide News

What Works to Increase Screening for Breast, Cervical and Colorectal Cancers: Findings of the Task Force on Community Preventive Services

The U.S. Task Force on Community Preventive Services (Task Force) released a set of recommendations about interventions designed to increase screening for breast, cervical and colorectal cancers. The Task Force recommendations and related findings are published in the July 2008 supplement of the American Journal of Preventive Medicine.  Public health practitioners, policy makers, researchers, and research funders may find these recommendations useful as they consider strategies for early detection of these types of cancers.

The Task Force—a non-federal volunteer group of public health and prevention experts appointed by the Director of the Centers for Disease Control and Prevention (CDC)—bases its findings on systematic reviews of published scientific studies on interventions used to increase cancer screening.  These systematic reviews are conducted for the Task Force by CDC’s Community Guide staff, in collaboration with federal and non-federal experts in research, practice, and policy.  Review methods are described in the American Journal of Preventive Medicine.

The Task Force considered Community Guide systematic reviews of interventions to promote breast, cervical and colorectal cancer screening in the three categories below.  Based on their assessment of the evidence of effectiveness of these interventions, the Task Force recommended a number of the interventions and found insufficient evidence to determine the effectiveness of others. Note that “Insufficient Evidence” does not mean that the intervention does not work, only that there is not yet enough evidence to determine whether or not it is effective.

• Health care provider-based interventions designed to increase offering or delivery of breast, cervical, and colorectal cancer screening services to clients:
  • Recommended:
    • Provider assessment and feedback (e.g., evaluating performance and sharing results with the provider) across all three cancer sites
    • Provider reminders (e.g., checklist, electronic message) across all three cancer sites
  • Insufficient Evidence:
    • Provider incentives (e.g., monetary reward, education credits) across all three cancer sites
• Client-based interventions designed to increase community demand for, or access to breast, cervical, or colorectal cancer screening:
  • Recommended:
    • Client reminders (e.g., postcard, phone call) for breast, cervical and colorectal cancer screening
    • Small media (e.g. flyers, newsletters) for breast, cervical and colorectal cancer screening
    • One-on-one education (e.g., by phone, face-to-face) for breast and cervical cancer screening
    • Reducing structural barriers (e.g., distance, hours open, language) for breast and colorectal cancer screening
    • Reducing out-of-pocket costs (e.g., no insurance coverage, co-payments) for breast cancer screening
  • Insufficient Evidence:
    • Group education (e.g., lecture, interactive, various settings) for breast, cervical and colorectal cancer screening
    • Client incentives (e.g., coupons, small cash rewards) for breast, cervical and colorectal cancer screening
    • Mass media (e.g., TV, radio, newspaper, billboards) for breast, cervical and colorectal cancer screening
    • One-on-one education for colorectal cancer screening
    • Reducing structural barriers for cervical cancer screening
    • Reducing out-of-pocket costs for cervical and colorectal cancer screening
• Multi-component interventions:
  • Recommended across all three cancer sites, when at least one of the components in the multi-component intervention is an intervention recommended by the Task Force

Learn more about these systematic reviews.