Promoting colorectal cancer screening: a systematic review and meta-analysis of randomised controlled trials of interventions to increase uptake
Abstract
Colorectal cancer (CRC) represents a global public health concern. CRC screening is associated with significant reductions in CRC incidence and mortality, however, uptake is suboptimal. This systematic review and meta-analysis of randomised controlled trials explored the effectiveness of interventions designed to increase screening uptake, plus the impact of various moderators. Data from 102 studies including 1.94 million participants were analysed. Results showed significant benefit of all interventions combined (OR, 1.49, 95% CI: 1.43, 1.56, p < 0.001). The effects were similar in studies using objective versus self-reported uptake measures and lower in studies judged to be at high risk of bias. Moderator analyses indicated significant effects for aspects of behaviour (effects lower for studies on non-endoscopic procedures), and intervention (effects higher for studies conducted in community settings, in healthcare systems that are not free, and that use reminders, health-professional providers, paper materials supplemented with in-person or phone contact, but avoid remote contact). Interventions that included behaviour change techniques targeting social support (unspecified or practical), instructions or demonstration of the behaviour, and that added objects to the environment produced stronger effects. The way in which findings can inform interventions to improve CRC screening uptake is discussed.
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Mixed contact has been more effective than remote contact alone.
“Mixed contact has been more effective than remote contact alone.”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [43]
Effective interventions have used face-to-face, remote or mixed contact.
“Effective interventions have used faceto-face, remote or mixed contact [43].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [43]
No significant difference has been found between mixed versus face-to-face contact and face-to-face versus remote contact.
“nificant difference has been found between mixed versus face-to-face contact and face-to-face versus remote contact [43].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [43]
For CRC, interventions provided by health professionals (clinically-trained or not) or research staff were significantly more effective at increasing screening uptake rates than those that did not include direct contact with participants.
“For CRC, interventions provided by health professionals (clinically-trained or not) or research staff were significantly more effective at increasing screening uptake rates than those that did not include direct contact with participants [43].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [43]
A meta-analysis found that general social support, practical social support, instructions on how to perform the behaviour, and demonstration of the behaviour were associated with increases in CRC screening.
“A meta-analysis found that general social support (e.g., encouragement), practical social support (e.g., assistance in booking an appointment), instructions on how to perform the behaviour (e.g., home-testing) and demonstration of the behaviour (e.g., how to use testing kits) were associated with increases in CRC screening [43].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [43]
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Flagged first, then by citations
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- Authors
- Tsipa, A., O’Connor, D. B., Branley-Bell, D., Day, F., Hall, L. H., Sykes-Muskett, B., Wilding, S., Taylor, N., & Conner, M.
- Affiliations
- University of Leeds (GB)
- School of Psychology, University of Leeds
- Northumbria University (GB)
- NHS Leeds West Clinical Commissioning Group
- The University of Sydney (AU)
- Corresponding author
- Conner, Mark
- Venue
- Health Psychology Review
- Publisher
- Informa UK Limited
- Published
- 2020-05-13
- Volume
- 15
- Issue
- 3
- Pages
- 371-394
- ISSN
- 1743-7199 (ISSN-L)
- 1743-7202
- OpenAlex
- W3024540246
- Cited by
- 46
- References
- 92
- Citations by year
- 2026: 17 · 2025: 7 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 5 · 2020: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Northumbria Research Link (Northumbria University) (acceptedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- colorectal cancer screening, screening uptake, behaviour change interventions, behaviour change techniques, social support, reminders, community-based intervention, endoscopic screening, intervention moderators
- MeSH terms
- Humans, Colorectal Neoplasms, Randomized Controlled Trials as Topic, Early Detection of Cancer
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