Journal
JOURNAL OF COMMUNITY HEALTH
Volume 46, Issue 1, Pages 232-244Publisher
SPRINGER
DOI: 10.1007/s10900-020-00867-z
Keywords
Colorectal cancer; Cancer screening; Stool blood tests; Colonoscopy; African Americans
Funding
- National Institute on Minority Health and Health Disparities of the National Institutes of Health [U54 MD007582]
- American Cancer Society, Institutional Research Grant through the Penn State Cancer Institute at Penn State Health Milton S. Hershey Medical Center
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African Americans experience disparities in colorectal cancer screening compared to other racial groups in the United States. Interventions such as mailed reminders, patient navigation, and tailored educational materials show promise in increasing participation rates in stool blood testing. More research is needed to determine the effectiveness of interventions in this population.
African Americans experience colorectal cancer (CRC) related disparities compared to other racial groups in the United States. African Americans are frequently diagnosed with CRC at a later stage, screening is underutilized, and mortality rates are highest in this group. This systematic review focused on intervention studies using stool blood CRC screening among African Americans in primary care and community settings. Given wide accessibility, low cost, and ease of dissemination of stool-based CRC screening tests, this review aims to determine effective interventions to improve participation rates. This systematic review included intervention studies published between January 1, 2000 and March 16, 2019. After reviewing an initial search of 650 studies, 11 studies were eventually included in this review. The included studies were studies conducted in community and clinical settings, using both inreach and outreach strategies to increase CRC screening. For each study, an unadjusted odds ratio (OR) for the CRC screening intervention compared to the control arm was calculated based on the data in each study to report effectiveness. The eleven studies together recruited a total of 3334 participants. The five studies using two-arm experimental designs ranged in effectiveness with ORs ranging from 1.1 to 13.0 using interventions such as mailed reminders, patient navigation, and tailored educational materials. Effective strategies to increase stool blood testing included mailed stool blood tests augmented by patient navigation, tailored educational materials, and follow-up calls or mailings to increase trust in the patient-provider relationship. More studies are needed on stool blood testing interventions to determine effectiveness in this population.
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