Rachel B. Issaka|Patrick Avila|Evans Whitaker|Stephen Bent|Ma Somsouk
Population health interventions to improve colorectal cancer screening by fecal immunochemical tests: A systematic review
Fred Hutch Cancer Center|University of Washington|University of California, San Francisco|University of California San Francisco Medical Center|University of California, San Francisco|University of California, San Francisco
despite clear evidence colorectal cancer crc screening reduces mortality screening including fecal immunochemical tests fit underutilized conducted systematic review determine evidence efficacy interventions improve fit completion could scaled utilized population health management systematically searched publication databases studies evaluating provider systemlevel interventions improve crc screening fit 1 january 1996 13 december 2017 without language restrictions twenty articles describing 25 studies included 23 randomized controlled trials 1 quasiexperimental 1 observational study ten studies discussed mailed fit outreach 4 prefit patient reminders 3 tailored patient messages 2 postfit reminders 2 paired fit influenza vaccinations 2 provider alerts 1 study described use highquality small media patient financial incentives mailed fit outreach consistently effective median improvement crc screening 215 interquartile range iqr 136290 fit paired vaccinations led median 159 iqr 156163 improvement prefit postfit reminders demonstrated modest efficacy median 41 iqr 3667 31 iqr 2933 improvement crc screening respectively half studies high unclear risk bias heterogeneous study designs characteristics precluded metaanalysis fitbased crc screening programs utilizing multilevel interventions eg mailed fit outreach fit paired preventative services provider alerts potential significantly increase screening participation however programs must also followup patients abnormal fit results