Reference | Setting | Participants | Intervention vs control | Outcome | Participation |
---|---|---|---|---|---|
Organised programmes | |||||
Tinmouth et al51 | Province-wide CRC screening programme Canada | Subjects aged 50–74 who had not responded to an invitation in the Colon Cancer Check pilot project | Intervention group: mailed gFOBT kit+reminder letter Enabling factors Control group: reminder letter | Uptake of gFOBT within 6 months | Intervention group: 20.1% (N=2008) Control group: 9.6% (N=1586) OR: 2.1; 95% CI 1.6 to 2.6 |
Van Roosbroeck et al52 | Population-based screening programme for CRC Belgium | 19 542 people aged 50–74 years who had not performed a colonoscopy in the past 10 years | Mail group: mailing of FIT kit+invitation letter Enabling factors GP group: invitation letter with instructions to pick up the kit by the GP | Participation following the initial or reminder invitation letter | Mail group (N=11 490) 52.3% (95% CI 51.3 to 53.2) GP group (N=8052) 27.7% (95% CI 26.7 to 28.6) OR=2.96, 95% CI 2.78 to 3.14 |
Giorgi Rossi et al53 | Organised screening programmes in three regions of Central Italy Italy | First RCT 3196 individuals who had previously participated in CRC screening in the previous round Second RCT 4219 people aged 50–69 years who did not respond to the first invitation | First RCT Intervention: mailing of FIT kit+invitation letter Enabling factors Control: invitation letter with instruction to pick up the kit at a primary care clinic Second RCT Intervention: mailing of FIT kit+invitation letter Enabling factors Control: invitation letter with instruction to pick up the kit at a primary care clinic | Participation in screening within 90 days of the mailing | First RCT Mailing 63.0% (N=1596) Control 56.8% (N=1600) RR=1.11 (95% CI 1.06 to 1.17) Second RCT Mailing 14.6% (N=2107) Control 10.7% (N=2112) RR=1.36 (95% CI 1.16 to 1.60) |
Federici et al54 | Pilot screening programme Italy | Subjects aged 50 to 69 listed in the rosters of 130 GPs: | GP provider arm: invitation letter signed by the GP, inviting the screenee to pick up and return the FOBT at the GP's office Hospital arm: invitation letter signed by the GP, inviting the screenee to pick up and return the FOBT at a hospital gastroenterology unit Enabling factors | FIT and gFOBT compliance | GP provider: 50.3% (N=3657) Hospital: 16.2% (N=3675) RR 3.4; 95% CI 3.13 to 3.70 |
Segnan et al55 | Pilot screening programme Italy | General population sample of 26 682 subjects listed in the National Health Service register | Group 1: invitation letter+FIT kit with instructions+information leaflet Enabling factors Group 2: invitation letter with instruction to pick up the kit in a pharmacy+information leaflet Predisposing factors Group 3: invitation letter with the offer to choose between FS and FIT+information leaflet Predisposing factors Group 4: invitation letter with prefixed appointment for FS+ information leaflet Enabling factors Group 5: invitation letter with prefixed appointment for FS followed by FIT (negative FS only) +information leaflet Enabling factors Invitation letters signed by the GP Mail reminders for non–responders | Screening FS or FIT or combination of the two tests | Group 1: 30.1% (682/2266) Group 2: 28.1% (1654/5893) Group 3: 27.1% (970/3579) Group 4: 28.1% (1026/3650) Group 5: 28.1% (3049/10 867) OR, 95% CI Group 5: 1.00 (referent) Group 4: 1.00 (0.92 to 1.09) Group 3: 0.95 (0.88 to 1.04) Group 2: 1.00 (0.93 to 1.07) Group 1: 1.11 (1.00 to 1.22) |
Opportunistic setting | |||||
Baker et al56 | Community health centresUSA | 450 subjects who had prior negative FOBT, underserved, mostly (87%) Latinos | I: usual care plus 1. A mailed reminder letter+a free FIT with low-literacy instructions, and a postage-paid return envelope 2. An automated reminder telephone and text 3. An automated telephone and text reminder 2 weeks later for those who did not return the FIT 4. Personal telephone outreach by a CRC screening navigator after 3 months Usual care: computerised reminders, clinic FIT, clinician feedback on CRC screening rates. Predisposing–enabling–reinforcing factors | FIT completion rate | Intervention: 82.2% (185/225) usual care: 37.3% (84/225) (p<0.001) |
Gupta et al45 | Community-based and hospital-based primary care clinics and a tertiary care hospital USA | 5970 participants—screening uninsured subjects overdue for CRC screening, age 54–64 years | FIT outreach: mailed invitation plus FIT kit TC outreach : mailed invitation to schedule free colonoscopy+phone triage to assess TC risk; +bowel prep—mail or pick up+appointment reminders and review of prep 5–7 days prior to TC Both groups included: 1. Invitation letter in English and Spanish 2. Two pre-recorded automated telephone messages 3. Up to 2 ‘live’ telephone follow-up reminders 4. Aid with scheduling and understanding preparation Usual care: visit-based offer to complete screening with gFOBT, TC, barium enema or sigmoidoscopy at the discretion of primary care providers Predisposing–enabling–reinforcing factors | Any CRC test within 1 year | FIT outreach 40.7% (648/1593) Colonoscopy outreach 24.6% (118/479) Usual care 12.1% (471/3898) (p<0.001 for either FIT or colonoscopy vs usual care) FIT outreach significantly greater than colonoscopy outreach (p<0.001) |
Sequist et al57 | 174 primary care physicians at 14 health centresUSA | Subjects overdue for screening aged 50–75 years | Group 1: electronic reminders, educational information, and link for additional information Group 2: usual care Predisposing–enabling factors | Any CRC screening | Group 1: 15.8% (N=552) Group 2: 13.1% (N=551) p=0.18 |
Sequist et al58 | Multispecialty group practice USA | 21 860 subjects overdue for screening | Group 1: educational pamphlet+mailing of FOBT kit with a stamped return envelope+phone number to schedule TC or FS+mail reminder Group 2: usual care Predisposing–enabling factors | Any CRC screening | Group 1: 44.0% (N=10 930) Group 2: 38.1% (N=10 930) p<0.001 |
Church et al59 | General population sample USA | Residents aged 50 years or older selected from State Driver's License and Identification Card database Total sample: N=1943 Estimated eligible participants. N=1394 | Group 1: mailing of FOBT kit+educational brochure Group 2: mailing of FOBT kit+educational brochure+phone call reminder Group 3: usual care+screening questionnaire Predisposing–enabling factors | 1-year self-reported screening rate | 1-year rate changes (self-reported FOBT use) Group 1: 16.9 (N=351) Group 2: 23.2% (N=390) Group 3: 1.5% (N=403) |
Courtier et al60 | Primary healthcare centre Spain | 2025 subjects aged 50–74 years attending a Primary Health Care centre | Group 1: mail invitation letter+2 containers for faecal sample collection Group 2: visit by a trained non-health professional who helped to collect the faecal sample Enabling–reinforcing factors | FOBT completion after intervention | Group 1: 67.5% (262/388) Group 2: 75.1% (419/557) p<0.014 |
Ore et al61 | Health Maintenance Organization Israel | 1940 men and women aged 50–74 years, residents of Haifa | Group 1: mailed FOBT kit and information leaflet about CRC risk and importance of early detection Group 2: FOBT kit request and information leaflet about CRC risks and importance of early detection Enabling factors | FOBT completion after intervention | Group 1: 19.9% (192/964) Group 2: 15.9% (155/976) p<0.05 |
CRC, colorectal cancer; FIT, faecal immunochemical test; FS, sigmoidoscopy; gFOBT, guaiac faecal occult blood test; GP, general practitioner; RCT, randomised controlled trial; TC, colonoscopy.