Mailed Outreach Is Superior to Usual Care Alone for Colorectal Cancer Screening in the USA: A Systematic Review and Meta-analysis.

Details

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_20B8B626AB58
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mailed Outreach Is Superior to Usual Care Alone for Colorectal Cancer Screening in the USA: A Systematic Review and Meta-analysis.
Journal
Digestive diseases and sciences
Author(s)
Jager M., Demb J., Asghar A., Selby K., Mello E.M., Heskett K.M., Lieberman A.J., Geng Z., Bharti B., Singh S., Gupta S.
ISSN
1573-2568 (Electronic)
ISSN-L
0163-2116
Publication state
Published
Issued date
09/2019
Peer-reviewed
Oui
Volume
64
Number
9
Pages
2489-2496
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Systematic Review
Publication Status: ppublish
Abstract
Mailed outreach promoting colorectal cancer (CRC) screening with a stool blood test kit may increase participation, but magnitude and consistency of benefit of this intervention strategy is uncertain. Our aim was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing mailed outreach offering stool tests to usual care, clinic-based screening offers on CRC screening uptake in the USA. We performed a systematic literature search of five databases for RCTs of mailed outreach from January 1980 through June 2017. Primary outcome was screening completion, summarized using random-effects meta-analysis as pooled differences in proportion completing the screening and relative risk of achieving screening compared to control. Subgroup analyses by test type offered-fecal immunochemical test (FIT) or guaiac fecal occult blood test (gFOBT), the presence of telephone reminders, and the presence of predominant underserved/minority population within study were performed. Quality of evidence was evaluated using the GRADE framework. Seven RCTs which enrolled 12,501 subjects were included (n = 5703 assigned mailed outreach and n = 6798 usual care). Mailed outreach resulted in a 28% absolute (95% CI 25-30%; I <sup>2</sup> = 47%) and a 2.8-fold relative (RR 2.65, 95% CI 2.03-3.45; I <sup>2</sup> = 92%) increase in screening completion compared to usual care, with a number needed to invite estimated to be 3.6. Similar outcomes were observed across subgroups. Overall body of evidence was at moderate quality. Mailed outreach offering a gFOBT or FIT is associated with a large and consistent increase in CRC screening completion and should be considered for more widespread implementation for improving screening rates nationwide.
Keywords
Colorectal Neoplasms/diagnosis, Correspondence as Topic, Early Detection of Cancer, Health Promotion/methods, Humans, Immunochemistry, Marketing of Health Services, Occult Blood, Patient Acceptance of Health Care/statistics & numerical data, Postal Service, Randomized Controlled Trials as Topic, United States, Cancer screening, Colorectal cancer, Meta-analyses, Systematic review
Pubmed
Web of science
Create date
14/04/2019 15:34
Last modification date
21/11/2022 8:25
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