The following is a summary of “Effect of Behavioral Interventions on the Uptake of Colonoscopy for Colorectal Cancer Screening: A Systematic Review and Meta-Analysis,” published in the October 2023 issue of Gastroenterology by Yakoubovitch, et al.
Colorectal cancer screening effectively reduces incidence and mortality from this disease, but its uptake in the United States is still not optimal. While various interventions have been studied for their impact on overall colorectal cancer screening, including stool-based tests, there was a gap in understanding the effectiveness of these interventions, specifically on colonoscopy, the primary screening method in the United States. To address this gap, a systematic review and meta-analysis were conducted by researchers to evaluate the influence of behavioral interventions on the completion of screening colonoscopy.
They extensively searched databases, including PubMed, Embase, and Cochrane, up to January 2022 to identify controlled trials investigating how behavioral interventions affected screening colonoscopy rates. Multiple independent reviewers screened the titles, abstracts, and full articles. Odds ratios were extracted from the original publications or calculated from raw data. The primary outcome measure was the relative increase in screening colonoscopy completion due to behavioral interventions. A random-effects meta-analysis was performed, and subgroup analyses were conducted based on the type of intervention.
A total of 25 studies involving 30 behavioral interventions were included in the analysis. The most common interventions were patient navigation (in 11 studies) and multicomponent interventions (in 6 studies). Behavioral interventions increased colonoscopy completion by 54% compared to control groups, with an odds ratio of 1.54 and a 95% CI of 1.26 to 1.88. Among the interventions studied in multiple trials, patient navigation had an odds ratio of 1.78 (95% CI 1.35–2.34), and multicomponent interventions had an odds ratio of 1.84 (95% CI 1.17–2.89), indicating their strong impact on increasing colonoscopy completion. Significant heterogeneity was observed both overall and when analyzing interventions by type, and no evidence of publication bias was found.
The results of the study suggested that behavioral interventions play a significant role in increasing the completion of screening colonoscopies. The findings had practical implications for clinical practice, highlighting the importance of incorporating such interventions into colorectal cancer screening programs. Notably, patient navigation and multicomponent interventions were well-supported and effective approaches to boost colonoscopy uptake.
Source: journals.lww.com/ajg/fulltext/2023/10000/effect_of_behavioral_interventions_on_the_uptake.27.aspx
