Journal Article

Interventions for increasing colorectal cancer screening uptake among African-American men: A systematic review and meta-analysis

Matthews, Phung, Huntington, Matthew, Okuyemi, Kola S., Le Duc, Nathan, Rogers, Charles R., Riley, Colin, Foster, Margaret J., Xu, Lei, Boucher, Kenneth

2020

Overview

African-American men have the lowest 5-year survival rate in the U.S. for colorectal cancer (CRC) of any racial group, which may partly stem from low screening adherence. It is imperative to synthesize the literature evaluating the effectiveness of interventions on CRC screening uptake in this population. In this systematic review and meta-analysis, Medline, CINAHL, Embase, and Cochrane CENTRAL were searched for U.S.-based interventions that: were published after 1998-January 2020; included African-American men; and evaluated CRC screening uptake explicitly. Checklist by Cochrane Collaboration and Joanna Brigg were utilized to assess risk of bias, and meta-regression and sensitivity analyses were employed to identify the most effective interventions. Our final sample comprised 41 studies with 2 focused exclusively on African-American men. The most frequently adopted interventions were educational materials (39%), stool-based screening kits (14%), and patient navigation (11%). Most randomized controlled trials failed to provide details about the blinding of the participant recruitment method, allocation concealment method, and/or the outcome assessment. Due to high heterogeneity, meta-analysis was conducted among 17 eligible studies. Interventions utilizing stool-based kits or patient navigation were most effective at increasing CRC screening completion, with odds ratios of 9.60 (95% CI 2.89-31.82, p = 0.0002) and 2.84 (95% CI 1.23-6.49, p = 0.01). No evidence of publication bias was present for this study registered with the International Prospective Registry of Systematic Reviews (PROSPERO 2019 CRD42019119510). Additional research is warranted to uncover effective, affordable interventions focused on increasing CRC screening completion among African-American men. When designing and implementing future multicomponent interventions, employing 4 or fewer interventions types may reduce bias risk. Since only 5% of the interventions solely focused on African-American men, future theory-driven interventions should consider recruiting samples comprised solely of this population.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: African American men / African Americans / Bias / Black or African American - psychology / Black or African American - statistics & numerical data / Cancer / Cancer screening / Clinical trials / Colonoscopy / Colorectal cancer / Colorectal carcinoma / Colorectal Neoplasms - diagnosis / Colorectal Neoplasms - prevention & control / Colorectal Neoplasms - psychology / Demographic aspects / Diagnosis / Early Detection of Cancer - psychology / Early Detection of Cancer - statistics & numerical data / Evaluation / Feces / Health aspects / Health Knowledge, Attitudes, Practice / Health promotion / Heterogeneity / Humans / Intervention / Literature reviews / Male / Medical research / Medical screening / Medicine and Health Sciences / Meta-analysis / Methods / Mortality / Patient Acceptance of Health Care - psychology / Patient Education as Topic - methods / People and places / Physical Sciences / Preventive medicine / Prognosis / Recruitment / Regression analysis / Research and Analysis Methods / Risk assessment / Risk factors / Sensitivity analysis / Survival / Systematic review / Underserved populations