What implementation interventions increase cancer screening rates? a systematic review

Melissa C Brouwers, Carol De Vito, Lavannya Bahirathan, Angela Carol, June C Carroll, Michelle Cotterchio, Maureen Dobbins, Barbara Lent, Cheryl Levitt, Nancy Lewis, S Elizabeth McGregor, Lawrence Paszat, Carol Rand, Nadine Wathen

Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests.