Abstract Background: Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States. Clinical guidelines recommended asymptomatic adults 45-75 years old at average-risk for CRC be routinely screened. Thus, screening is a continual process that spans several years. Patients with negative screening tests should rescreen following the timeline set by guidelines, which can be 1-10 years, depending on the screening test. For patients with a positive stool-based test, guidelines recommend a follow-up diagnostic colonoscopy. Several challenges limit both one-time and repeat adherence to CRC screening. This targeted literature review focuses on patient intervention strategies and the effects of these strategies on patient uptake of follow-up colonoscopy and repeat (longitudinal) CRC screening. Methods: Google scholar was utilized to conduct and analyze published literature pertaining to patient intervention strategies after initial screening for both positive and negative resulting tests for CRC screening as well as other cancer screenings. Related studies published from 2008 until 2024 were analyzed. Strategies after an initial screening were reviewed for both CRC and other cancers, such as breast and lung cancer, to compare the differences in outreach strategies. Results: In total, 24 studies were reviewed. 13 of these studies assessed patient intervention strategies after an initial positive test result, and 11 assessed strategies after an initial negative test result. In multiple conducted trials, the literature suggested that the most effective patient intervention strategy after an initial positive screening result is the utilization of patient navigation programs. These programs help improve successful follow-up diagnostic solutions (colonoscopy in the case of CRC). The care and attention patients experience through these programs has been suggested to be the cause of the improvements in follow-up. Multimodal intervention strategies (a combination of traditional mail, automated text messaging, automated phone calls, and live phone calls) have been observed to be the most effective in retaining longitudinal adherence to rescreening for negative-tested patients. The literature suggests that effective intervention strategies should include wording and messaging be clear, concise, and encourage patients to take the next steps after the initial screening. Conclusion: From the results of the literature review, strategies including patient navigation programs, as well as multimodal intervention strategies such as multiple languages offered, information delivery (phone, mail, patient portal, and email) are effective outreach protocols to engage and keep patients up to date on steps after a CRC screening test result, thus possibly reducing the number of CRC related deaths. Citation Format: Mariah Lilly, Gail Foster, Theresa Hoang, Victoria Raymond. A literature review on patient intervention strategies to improve cancer screening adherence abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C148.
Lilly et al. (Thu,) studied this question.
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