Optimizing Colorectal Cancer Screening Acceptance
Optimizing Colorectal Cancer Screening Acceptance
We searched in first instance recent systematic reviews (SR) and meta-analyses addressing the same topics of our study on PubMed, Embase, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects. The search was based on the strategy used in the SR by Jepson et al with appropriate changes according to our inclusion criteria and databases. Relevant original articles published before August 2012 (search update of the most recent review) were retrieved through already published reviews. We subsequently searched PubMed, Embase and CENTRAL for randomised controlled trials (RCTs), reporting comparative evaluations of interventions, published until 15 October 2014. See online supplementary appendix 1 http://gut.bmj.com/content/64/7/1158/suppl/DC1 for the details of the search strategies.
We excluded small-size trials (≤100 subjects per arm) and those reports preceding the publication of the European population-based trials documenting the effectiveness of guaiac FOBT (gFOBT) screening. The findings concerning the impact of interventions conducted when evidence of screening effectiveness was still lacking might not be comparable to those reported from more recent trials, implemented following endorsement of CRC screening by professional societies and governmental institutions. Observational studies were considered when assessing policy options, not easily amenable to testing by RCTs.
The outcome of interest in the context of organised programmes was the participation in the first-level screening test, defined as the proportion of invited subjects who underwent the test. In opportunistic settings, the outcome considered was test coverage, defined as the proportion of the target population who had a test within the recommended interval. Interventions have been categorised according to the targeted level of the healthcare system, taking into account the specific behavioural mechanism involved and the screening model (opportunistic vs organised).
Methods
Literature Search
We searched in first instance recent systematic reviews (SR) and meta-analyses addressing the same topics of our study on PubMed, Embase, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects. The search was based on the strategy used in the SR by Jepson et al with appropriate changes according to our inclusion criteria and databases. Relevant original articles published before August 2012 (search update of the most recent review) were retrieved through already published reviews. We subsequently searched PubMed, Embase and CENTRAL for randomised controlled trials (RCTs), reporting comparative evaluations of interventions, published until 15 October 2014. See online supplementary appendix 1 http://gut.bmj.com/content/64/7/1158/suppl/DC1 for the details of the search strategies.
We excluded small-size trials (≤100 subjects per arm) and those reports preceding the publication of the European population-based trials documenting the effectiveness of guaiac FOBT (gFOBT) screening. The findings concerning the impact of interventions conducted when evidence of screening effectiveness was still lacking might not be comparable to those reported from more recent trials, implemented following endorsement of CRC screening by professional societies and governmental institutions. Observational studies were considered when assessing policy options, not easily amenable to testing by RCTs.
The outcome of interest in the context of organised programmes was the participation in the first-level screening test, defined as the proportion of invited subjects who underwent the test. In opportunistic settings, the outcome considered was test coverage, defined as the proportion of the target population who had a test within the recommended interval. Interventions have been categorised according to the targeted level of the healthcare system, taking into account the specific behavioural mechanism involved and the screening model (opportunistic vs organised).