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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State: Public
Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_20B8B626AB58
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
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
04/09/2020 6:08
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