Overall, the median cost per participant was $36.63 (42 study arms).All monetary values are reported in 2016 U.S. The majority of these studies were conducted in the United States with 9 studies conducted in other high-income countries. Studies evaluated interventions that used FOBT (26 studies), colonoscopy (8 studies), and flexible sigmoidoscopy (1 study). Two studies focused on both breast and colorectal cancer screening. Results also showed the interventions led to cost savings from averted treatment costs that exceed intervention costs.Ī systematic search for economic evidence (search period January 2004 January 2018) identified 53 studies, 33 of which focused on colorectal cancer screening. The CPSTF finds that multicomponent interventions to increase screening for colorectal cancer are cost-effective. None of the included studies evaluated interventions that provided child care.Addressing transportation needs led to the next largest increase (median increase of 18.4 percentage points, 11 studies).Providing language translation services led to the largest increase (median increase of 62.7 percentage points, 4 studies).Multicomponent interventions that included approaches to reduce structural barriers increased cancer screening rates.Cancer screening increased independent of which approaches were used.Interventions that used five or more approaches showed a larger increase than interventions with fewer approaches.Multicomponent interventions that used two or more approaches increased cancer screening.Multicomponent interventions that used strategies to increase community demand and access increased cancer screening by a median of 11.2 percentage points (48 study arms).Multicomponent interventions that used all three strategies increased cancer screening by a median of 24.2 percentage points (5 study arms).Intervention approaches are categorized into three strategies: increasing community demand, increasing community access, or increasing provider delivery of screening.Studies of interventions to increase breast, cervical, and colorectal cancer screening were considered for these analyses.The review team conducted stratified analyses to understand the influence of these factors on cancer screening use. Multicomponent interventions vary in the number and type of approaches or strategies used.Flexible sigmoidoscopy: median decrease of 0.5 percentage points (5 study arms).FOBT: median increase of 7.7 percentage points (21 study arms).Colonoscopy: median increase of 10.2 percentage points (9 study arms).Any test (colonoscopy, FOBT, or flexible sigmoidoscopy): median increase of 15.4 percentage points (39 study arms).Compared with no intervention, multicomponent interventions changed colorectal cancer screening using the following tests:.Multicomponent interventions to increase cancer screening may be coordinated through healthcare systems, delivered in community settings, or both.ĭetailed results from the systematic review are available in the CPSTF Finding and Rationale Statement. Providing language translation services.Interventions reducing structural barriers include the following: Interventions to increase provider delivery of screening services: provider assessment and feedback, provider incentives, and provider reminders.Interventions to increase community access: reducing structural barriers and reducing client out-of-pocket costs.Interventions to increase community demand: client reminders, client incentives, small media, mass media, group education, and one-on-one education.Intervention approaches reviewed by the CPSTF are grouped into three strategies. Multicomponent interventions combine two or more intervention approaches reviewed by the Community Preventive Services Task Force, or two or more interventions to reduce structural barriers. The CPSTF has related findings for multicomponent interventions specific to the following: The Community Preventive Services Task Force finds that multicomponent interventions to increase screening for colorectal cancers are cost-effective. If interventions provide access to appropriate follow-up care and treatment, they may improve health for these groups. Multicomponent interventions can be used to increase screening use among underserved populations. The greatest effects come, however, when these two strategies are used together with the strategy to increase provider delivery of services. Interventions are effective in increasing screening with colonoscopy or fecal occult blood test (FOBT).Įvidence suggests multicomponent interventions lead to greater effects when they combine strategies to increase community demand for, and access to, cancer screening. The Community Preventive Services Task Force (CPSTF) recommends multicomponent interventions to increase screening for colorectal cancer.
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