Interventions to increase colorectal cancer screening among African Americans: A systematic review

Colorectal cancer (CRC) continues to affect African Americans disproportionately. Despite medical advances and widely accepted screening recommendations, African Americans are less likely to get appropriate CRC screening, and consequently, are more likely to die from colorectal cancer than their white counterparts. Appropriate communication between the patient and the provider and the need for increased patient education may be a part of the solution to this discouraging problem. Increasing provider education and cultural awareness may increase CRC screening among African Americans. The objective of this Capstone was to perform a systematic review of the published literature to assess the effectiveness of interventions aimed to increase participation in colorectal cancer screening among African Americans. Seven online databases were systematically searched for articles published between January 2000 and December 2007, using subject terms taken from the Medical Subject Headings (MeSH), the list of standardized descriptors used by the National Library of Medicine (NLM), to standardize the search. Studies that measured CRC screening rates and met the inclusion/exclusion criteria were selected. Data was extracted and independently reviewed by three reviewers. Study design, population characteristics, experimental intervention, control intervention and outcomes were extracted from the selected articles. Of the 392 studies identified, seven articles were selected for this review. Four articles reported the use of culturally tailored interventions and three articles did not use culturally tailored interventions. Two studies had interventions aimed at physician education. Three articles reported statistically significant results. Because of the limited number of quality studies, no conclusive recommendations can be made regarding the contribution of culturally tailored interventions towards increasing CRC screening among African Americans.