Cited by 46Colorectal Cancer Screening and DetectionGlobal Cancer Incidence and ScreeningHealth Promotion and Cardiovascular Prevention

Promoting colorectal cancer screening: a systematic review and meta-analysis of randomised controlled trials of interventions to increase uptake

Tsipa, Anastasia, O’Connor, Daryl B., Branley-Bell, Dawn, Day, Fiona, Hall, Louise H., Sykes-Muskett, Bianca, Wilding, Sarah, Taylor, Natalie +1 more·2021·Health Psychology Review

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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  1. Jepson, R., Clegg, A., Forbes, C., Lewis, R., Sowden, A., &amp; Kleijnen, J. (2000). The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technology Assessment (Winchester, England) , 4 (14), i-vii, 1-133.
  2. Norman, P., Boer, H., Seydel, E.R., &amp; Mullen, B. (2015). Protection motivation theory. In M. Conner &amp; P. Norman (Eds.), Predicting and changing health behaviour: Research and practice with social cognition models (3 rd Edn.; pp. 70-106). Maidenhead: Open University Press.

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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
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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