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Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review

Review

. 2021 Dec;28(4):379-388. doi: 10.1177/0969141321997482. Epub 2021 Mar 8. Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review

Affiliations

¹ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
² College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
³ Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
⁴ Division of Gastroenterology, University of California, San Francisco, CA, USA.
⁵ University of California San Francisco Medical Library, University of California, San Francisco, CA, USA.
⁶ Clinical Research and Public Health Science Divisions, Fred Hutchinson, Seattle, WA, USA.
⁷ Division of Gastroenterology, University of Washington, Seattle, WA, USA.
⁸ Center for Vulnerable Populations, University of California, San Francisco, CA, USA.

PMID: 33683155
PMCID: PMC8423851
DOI: 10.1177/0969141321997482

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Review

Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review

Andrew Wang et al. J Med Screen. 2021 Dec.

. 2021 Dec;28(4):379-388. doi: 10.1177/0969141321997482. Epub 2021 Mar 8. Affiliations

¹ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
² College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
³ Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
⁴ Division of Gastroenterology, University of California, San Francisco, CA, USA.
⁵ University of California San Francisco Medical Library, University of California, San Francisco, CA, USA.
⁶ Clinical Research and Public Health Science Divisions, Fred Hutchinson, Seattle, WA, USA.
⁷ Division of Gastroenterology, University of Washington, Seattle, WA, USA.
⁸ Center for Vulnerable Populations, University of California, San Francisco, CA, USA.

PMID: 33683155
PMCID: PMC8423851
DOI: 10.1177/0969141321997482

Item in Clipboard

Abstract

Objective: Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems.

Methods: We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated (n = 0). No language exclusions were applied.

Results: Common criteria for outreach exclusion included: being up-to-date with routine CRC screening (n = 22), comorbidities (n = 20), and personal history (n = 22) or family history of cancer (n = 9). Key informant surveys and interviews were performed (n = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic (n = 8, 31.0-59.6%), integrated health system (n = 5, 21.2-82.7%), and national regional CRC screening programs (n = 17, 23.0-64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate.

Conclusion: This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.

Keywords: Colon cancer; exclusionary factors organized screening; patient selection criteria; quality indicators.

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Conflict of interest statement

DECLARATION OF CONFLICTING INTERESTS

The Authors declares that there is no conflict of interest.

Figures
Figure 1.

Flow chart of study selection…

Figure 1.

Flow chart of study selection to evaluate implementation strategies that select patients for…

Figure 1.

Flow chart of study selection to evaluate implementation strategies that select patients for colorectal cancer screening program is community-based healthcare systems.