Review Article

Public Awareness of Colorectal Cancer Screening: Knowledge, Attitudes, and Interventions for Increasing Screening Uptake

Table 5

Randomized controlled trials for reduction of structural barriers and out-of-pocket costs as interventional strategy.

AuthorAimInterventionParticipants
( )
Participation,
(%)

Mant et al. (1992) [63] FOBT completion after interventionGroup 1: posted FOBT40425.5
Group 2: posted FOBT and invitation to health check39731.7*
Group 3: invitation to health check explaining that a FOBT would be offered at the appointment40220.6

Miller and Wong (1993) [64] FOBT completion after interventionGroup 1: prepared FOBT kits with prepaid postage15974*
Group 2: usual care16661

Freedman and Mitchell (1994) [65] FOBT completion after interventionGroup 1: returning FOBT by hand14637
Group 2: returning FOBT by mail57
Group 3: returning FOBT with prepaid postage71*

Ore et al. (2001) [66] FOBT completion after interventionGroup 1: mailed FOBT kit and information leaflet about CRC risks and importance of early detection97619.9*
Group 2: FOBT kit request and information leaflet about CRC risks and importance of early detection86415.9

Courtier et al. (2002) [67] FOBT completion after interventionGroup 1: mail invitation letter together with two containers for faecal sample collection 106068*
Group 2: visit by a trained nonhealth professional who helped to collect the faecal sample96575

Church et al. (2004) [17] Any screening test after interventionGroup 1: mailed FOBT and educational brochure125513.2*
Group 2: same as Group 1 and phone call reminder14.1
Group 3: just mailed FOBT7.8

Segnan et al. (2005) [18] Screening FS or FOBT after interventionGroup 1: mailed invitation to biennial FOBT, FOBT, instructions, educational leaflet, and 2 reminder letters2668230
Group 2: biennial FOBT delivered by the PCP or screening facility28
Group 3: same as Group 1 and invitation to choose between FOBT and once only FS27
Group 4: same as Group 1 and mailed invitation to FS28
Group 5: same as Group 1 and invitation to FS followed by biennial FOBT 28

Jandorf et al. (2005) [50] CRC screening after interventionGroup 1: patient navigator (written reminders, phone calls, scheduling assistance, and encouraging participation)3823.7*
Group 2: usual care405

Dietrich et al. (2006) [53] Any CRC screening after interventionGroup 1: educational brochure and 4 support calls by prevention care managers (provided motivational support, sent reminders and FOBT, arranged transportation, etc.)69663* 
43 (FOBT)
Group 2: single telephone call answering questions about screening and recommendations to order screening 69450
31 (FOBT)

Beach et al. (2007) [55] Any CRC screening after interventionGroup 1: prevention care managers (telephone reminders, emotional support, overcoming screening barriers, and scheduling screening appointments)52853*
Group 2: usual care 54238

Dietrich et al. (2007) [54] Any CRC screening after interventionGroup 1: trained bilingual outreach specialist (telephone calls recommending screening) and mailed educational material65325*
Group 2: prevention care managers (telephone calls recommending screening and discussing barriers against screening), material about overcoming barriers, and support scheduling screening appointments66332

Percac-Lima et al. (2009) [42] Any CRC screening after interventionGroup 1: introductory letter + educational material + phone or in-person contact by language-concordant navigator (community health workers)40927* 
21 (colonoscopy)*
Group 2: usual care 81412
10 (colonoscopy)

Sequist et al. (2009) [22] Any screening test after interventionGroup 1: educational pamphlet, mailed FOBT with a stamped return envelope, telephone number to schedule colonoscopy or flexible sigmoidoscopy, and mailed reminder1093044*
Group 2: usual care1093038.1

Potter et al. (2009) [68] Screening FOBT after interventionGroup 1: influenza vaccination, colourful multilingual education sheet and FOBT kit, and stamped return envelope.24657.3
Group 2: influenza vaccination (usual care)26884.3

Blumenthal et al. (2010) [57] CRC screening after interventionGroup 1: introductory meetings and written information (CRC screening information and National Cancer Institute pamphlet) 6217.7
Group 2: same as group 1 and 3 sessions (45 minutes) with a health educator (one-to-one)6322.2
Group 3: same as Group 3 but in groups of 4–14 participants (group education)6725.4
Group 4: same as Group 1 and financial support covering (covering screening, transportation, and other nonmedical expenses) 6533.9*†

Lasser et al. (2011) [46] Colonoscopy or FOBT screening after interventionGroup 1: introductory letter with educational material and patient navigation-based intervention (phone calls offering CRC screening)23533.6*‡
Group 2: usual care23020

Coronado et al. (2011) [26] Screening FOBT after interventionGroup 1: usual care1952*
Group 2: mailed FOBT and instructions16826
Group 3: same as Group 2, phone call reminder and home visit by trained community members addressing strategies for CRC screening and definition of CRC16831

Hoffman et al. (2011) [69] FOBT/colonoscopy screening after interventionGroup 1: electronic medical record, and mailed gFOBT322148.5*
Groups 2, 3, and 4: CRC screening offered in a clinic318418.6; 14.3; 18.8

Potter et al. (2011) [70] CRC screening during Flu campaignsGroup 1: nurse offering FOBT to patients waiting for their influenza vaccination and an envelope for mailing the FOBT kits, and a reminder 1 month later69530.3*
Group 2: usual care (only received influenza vaccination)67713.7

Statistically significant ( ).
Statistically significant Group 4 versus Group 1.
More beneficial for patients whose primary language was not English.