Abstract C70: A community guide systematic review of multicomponent interventions to increase breast, cervical, and colorectal cancer screening: Findings in underserved populations

Abstract

Abstract Background: Underserved adults are disproportionately not up-to-date with cancer screening. This systematic review examined effectiveness of multicomponent interventions (MCIs) to increase breast, cervical, and colorectal cancer (CRC) screening. Special attention was paid to underserved populations and interventions that engage community health workers (CHWs) and patient navigators (PNs). Methods: This systematic review consists of studies in high-income countries with eligible screening outcomes (recent or repeat mammography, Pap test, or CRC screening). Summary effects were calculated and stratified by income, insurance, involvement of Federally Qualified Health Centers (FQHCs) or community health centers (CHCs), and involvement of CHWs and PNs. Results: Eighty-eight studies were included. Among majority low-income populations, MCIs increased breast (median increase 10.5 percentage points (pp), interquartile interval (IQI) 6.5-25.7; 10 arms), cervical (median 7.0 pp, IQI 5.3-58.9; 7 arms), and CRC screening (median 15.5 pp, IQI 6.9-23.6; 13 arms). Screening use increased among majority uninsured populations across all three cancers (median 31.8 pp, range 23.2-40; 3 arms). MCIs involving FQHCs or CHCs increased breast and cervical (median 7.0 pp, IQI 2.3-11.0; 5 arms) and CRC screening (median 16.3 pp, IQI 13.9-23.8; 8 arms). Interventions engaging CHWs and PNs among low-income, majority-uninsured populations, or those utilizing FQHCs or CHCs also increased screening use across all three cancer types combined (CHWs: median 15.5 pp, IQI 5.8-60.1; 10 arms; PNs: median 11.9 pp, IQI 7.0-15.5; 11 arms). Conclusions: MCIs targeting underserved populations are effective in increasing breast, cervical, and CRC screening. MCIs engaging CHWs and PNs are effective among these populations. Citation Format: Devon Okasako-Schmucker, Yinan Peng, Susan Sabatino, Ismaila Ramon, Kristin Tansil Roberts, Shawna L. Mercer, Randy Elder. A community guide systematic review of multicomponent interventions to increase breast, cervical, and colorectal cancer screening: Findings in underserved populations [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C70.