Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Research ArticleVolume 4 Issue 9

Strategies to Increase Colorectal Cancer Screening Rates in Moderate-Risk Population: A Systematic Review

Iure Kalinine F Souza MD PhD1*, Luiza A Diniz2, Érico Henrique A de Morais2, Raquel M Carvalho2, Rayane Elen F Silva2, Camila G Mendes MSc3 and Eduardo Angelo Braga MD PhD1

1Department of Surgery, Gynecology-Obstetrics and Propaedeutics, School of Medicine, Federal University of Ouro Preto, Brazil
2School of Medicine, Federal University of Ouro Preto, Brazil
3Department of Pediatrics, Federal University of Minas Gerais, Brazil

*Corresponding Author: Érico Henrique Araújo de Morais, Department of Surgery, Gynecology and Obstetrics and Propaedeutics, Federal University of Ouro Preto, Brazil.

Received: August 06, 2021; Published: 00-00

Citation: Iure Kalinine F Souza., et al. “Strategies to Increase Colorectal Cancer Screening Rates in Moderate-Risk Population: A Systematic Review". Acta Scientific Gastrointestinal Disorders 4.9 (2021): 34-42.


  Evidence from randomized intervention studies indicates that colorectal cancer (CRC) screening is effective in reducing mortality. Thus, this systematic review is aimed to evaluate the factors associated with the success of strategies that increased the adherence to CRC screening tests by medium-risk patients. We grouped each strategy in clusters according to its interventions. Two articles addressing screening by recommendation/education of medical professionals presented an increase of 12.4% and 2.2 times more chance of patients completing screening tests; three resorted to recommendation/education of non-medical health professionals or assistant researchers, in which compliance went from 1% to 29% and 1.6 times more chance of following it through; four used recommendation/education of trained members of the community, in which there were an increase from 6.6% to 26.4%; two provided free FOBT kits available at post offices and pharmacies, in which the increase was of 29.8% to 30%; one sent pamphlets/invitations by mail or inviting patients by phone, in which growth varied from 1.1% to 13.7%; three educated the population via multimedia, which increased the rate to 14% or 15%; five used a mix of interventions, resulting in a growth from 1.7% to 76.9%. The rate increase in adherence to CRC screening tests relates to the guidance provided by a trained multidisciplinary team. Also, the patient-centered clinical method attends to the patient's singularities and thereby uses the best screening methodology based on updated scientific evidence for each population. Moreover, sending personalized newsletters and strengthening contact with patients via phone call/multimedia also increase success chances.

Keywords: Cancer; Colorectal Neoplasms; Diagnosis; Early Intervention; Health Education; Screening; Strategy


  1. Biller Leah H and Deborah Schrag. “Diagnosis and Treatment of Metastatic Colorectal Cancer: A Review”. The Journal of the American Medical Association7 (2021): 669-685.
  2. Bray Freddie., et al. “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries”. CA: A Cancer Journal for Clinicians6 (2018): 394-424.
  3. Maheri Mina., et al. “The effect of educational intervention based on theory of planned behavior on the improvement of colorectal cancer screening intention among average-risk individuals referring to Asadabad city clinics”. Journal of Education and Health Promotion 10 57.27 (2021).
  4. Ahmed Sunjida., et al. “Nuclear factor-kappaB in inflammatory bowel disease and colorectal cancer”. The American Journal of Digestive Diseases 1 (2014): 84-96.
  5. Mattiuzzi Camilla., et al. “Concise update on colorectal cancer epidemiology”. Annals of Translational Medicine21 (2019): 609.
  6. Fu Qiang., et al. “A meta-analysis of case-control studies of high-fat diet and colorectal cancer”. American Journal Digestive Disease2 (2014): 127-135.
  7. Menon Usha., et al. “A randomized trial comparing the effect of two phone-based interventions on colorectal cancer screening adherence”. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine3 (2011): 294-303.
  8. Davis Terry C., et al. “Contrasts in rural and urban barriers to colorectal cancer screening”. American Journal of Health Behavior3 (2013): 289-298.
  9. Hoffman-Goetz Laurie., et al. “Reasons for declining colorectal cancer screening by older Canadians: a pilot study”. Journal of Cancer Education: the Official Journal of the American Association for Cancer Education1 (2008): 32-36.
  10. Lim Brian S., et al. “The effect of MiraLAX/Gatorade bowel preparation versus Golytely on adenoma detection rate and interval to subsequent colonoscopy”. American Journal Digestive Disease2 (2017): 13-18.
  11. Cai Shan-Rong., et al. “Barriers to colorectal cancer screening: a case-control study”. World Journal of Gastroenterology20 (2009): 2531-2536.
  12. Merten Julie Williams., et al. “Barriers to cancer screening for people with disabilities: a literature review”. Disability and Health Journal1 (2015): 9-16.
  13. Shamseer Larissa., et al. “Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation”. British Medical Journal 350 (2015): 7647.
  14. Higgins Julian P T., et al. “The Cochrane Collaboration's tool for assessing risk of bias in randomised trials”. British Medical Journal 343 (2011): d5928.
  15. Aubin-Auger I., et al. “Efficacy of communication skills training on colorectal cancer screening by GPs: a cluster randomised controlled trial”. European Journal of Cancer Care1 (2016): 18-26.
  16. Dignan Mark., et al. “Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky”. Preventive Medicine 58 (2014): 70-74.
  17. Davis Terry., et al. “Improving colon cancer screening in community clinics”. Cancer 21 (2013): 3879-3886.
  18. Abuadas Fuad H., et al. “The Effect of a Health Education Intervention on Jordanian Participants' Colorectal Cancer Knowledge, Health Perceptions, and Screening Practices”. Cancer Nursing3 (2018): 226-237.
  19. Nguyen Tung T., et al. “Colorectal Cancer Screening and Chinese Americans: Efficacy of Lay Health Worker Outreach and Print Materials”. American Journal of Preventive Medicine3 (2017): e67-e76.
  20. Wang Jun., et al. “Engaging traditional medicine providers in colorectal cancer screening education in a chinese american community: a pilot study”. Preventing Chronic Disease 11 (2014): E217.
  21. Tong Elisa K., et al. “Lay health educators increase colorectal cancer screening among Hmong Americans: A cluster randomized controlled trial”. Cancer 1 (2017): 98-106.
  22. Briant Katherine J., et al. “Using a Culturally Tailored Intervention to Increase Colorectal Cancer Knowledge and Screening among Hispanics in a Rural Community”. Cancer Epidemiology, Biomarkers and Prevention: a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology 11 (2018): 1283-1288.
  23. Potter Michael B., et al. “Offering annual fecal occult blood tests at annual flu shot clinics increases colorectal cancer screening rates”. Annals of Family Medicine 1 (2009): 17-23.
  24. Schneider Tamera R., et al. “Promoting colorectal cancer screening in public health outreach campaigns”. Human Factors 6 (2011): 637-646.
  25. Dietrich Allen J., et al. “Telephone outreach to increase colon cancer screening in medicaid managed care organizations: a randomized controlled trial”. Annals of Family Medicine4 (2013): 335-343.
  26. Lee Hee Yun., et al. “Motivating underserved Vietnamese Americans to obtain colorectal cancer screening: evaluation of a culturally tailored DVD intervention”. Asian Pacific Journal of Cancer Prevention: APJCP4 (2014): 1791-1796.
  27. Zapka Jane G., et al. “Patient education for colon cancer screening: a randomized trial of a video mailed before a physical examination”. Annals of Internal Medicine9 (2004): 683-692.
  28. Devereux, Paul         , et al. “r”.            Health    Promotion                  Practice                   20.1         (2019):  85-93.
  29. Sequist Thomas D., et al. “Patient and physician reminders to promote colorectal cancer screening: a randomized controlled trial”. Archives of Internal Medicine4 (2009): 364-371.
  30. Arsenault Paul R., et al. “The Use of the Whole Primary-Care Team, Including Community Health Workers, to Achieve Success in Increasing Colon Cancer Screening Rate”. Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality2 (2016): 76-83.
  31. Arnold Connie L., et al. “Third Annual Fecal Occult Blood Testing in Community Health Clinics”. American Journal of Health Behavior3 (2016): 302-309.
  32. White Becky., et al. “Piloting the Impact of Three Interventions on Guaiac Faecal Occult Blood Test Uptake within the NHS Bowel Cancer Screening Programme”. BioMed Research International (2015): 928251.
  33. Pisera Malgorzata., et al. “Reinvitation to screening colonoscopy: a randomized-controlled trial of reminding letter and invitation to educational meeting on attendance in nonresponders to initial invitation to screening colonoscopy (REINVITE)”. European Journal of Gastroenterology and Hepatology5 (2016): 538-542.
  34. Little Paul., et al. “Preferences of patients for patient centred approach to consultation in primary care: observational study”. British Medical Journal7284 (2001): 468.
  35. Berkhof Marianne., et al. “Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews”. Patient Education and Counseling2 (2011): 152-162.
  36. Kaminski MF., et al. “The NordICC Study: rationale and design of a randomized trial on colonoscopy screening for colorectal cancer”. Endoscopy 7 (2012): 695-702.

Copyright: © Iure Kalinine F Souza., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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