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Cancer Screening: Small Media Targeting Clients – Colorectal Cancer

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What the CPSTF Found

About The Systematic Review

The CPSTF finding for small media to increase colorectal cancer screening by FOBT is based on evidence from a systematic review of 7 studies (search period 1966 - 2004). No studies were included for interventions to increase colorectal cancer screening by flexible sigmoidoscopy, colonoscopy, or double contrast barium enema.

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to cancer prevention and control.

Summary of Results

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 1.05 MB].

Seven studies on interventions to increase colorectal cancer screening by FOBT were included in the systematic review.

  • Proportion of study participants completing screening by FOBT: median increase of 12.7 percentage points (Interquartile interval: 0 to 26.4 percentage points; 8 study arms)

No studies were included for interventions to increase colorectal cancer screening by flexible sigmoidoscopy, colonoscopy, or double contrast barium enema.

Summary of Economic Evidence

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 1.05 MB].

Two studies qualified for the review of interventions to increase colorectal cancer screening by FOBT. Monetary values are presented in 2009 U.S dollars.

  • One study reported the average intervention cost was $150 per person screened.
  • One study found the cost per additional person screened was $44.49.

Applicability

Findings should apply to a range of populations and settings, provided the intervention is appropriately adapted to the target population and delivery context.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base.

  • Does effectiveness of small media differ by choice of medium (e.g., letter, video, brochure, or Internet-delivered application), information source (e.g., personal physician, educator), or intensity or frequency of delivery?
  • What is the relative cost effectiveness of tailored versus untailored messages?
  • How does the effectiveness of interventions to increase community demand for screening vary with the health literacy of a target population or subpopulation?
  • How can newer methods of communication—including automated telephone calls and Internet-delivered applications—be used to improve delivery, acceptance, and effectiveness of these interventions?
  • How effective are these interventions in increasing screening by colorectal endoscopy or by double contrast barium enema (for which no qualifying studies were identified)?
  • What is required to disseminate and implement effective interventions in community settings across the United States?
  • How can or should these approaches be applied to assure that screening, once initiated, is maintained at recommended intervals?
  • With respect to interventions that may be tailored to individuals, how are effective tailoring programs adapted, disseminated, and implemented in community-based settings across the United States?

Study Characteristics

  • Evaluated interventions used a personal record booklet; leaflets or pamphlets; videos, newsletters, or other printed materials; or a sequence of two letters.
  • Studies were conducted in urban and rural populations and included study participants from both clinical and community settings.
  • Of the 7 included studies, only one evaluated a tailored intervention.

Publications