Effectiveness of patient-targeted interventions to increase cancer screening participation in rural areas: A systematic review

Background: Cancer is a major public health problem worldwide. The GLOBOCAN estimated 18.1 million new cases of cancer and 9.6 million deaths from cancer in 2018. In some of the more frequent cancers, mortality can be significantly reduced through cancer screening programs. Nevertheless, socially disadvantaged groups have difficulties in benefitting from these screening programs, especially rural populations. Objective: To identify, characterize and summarize patient-targeted interventions aimed at increasing cancer screening participation among rural populations. Methods: An exhaustive literature search was performed in the most relevant bibliographic databases for biomedical research. The systematic review was reported according to the PRISMA guidelines. Results: Twenty studies assessing 37 interventions were identified. Most of the studies were conducted in the United States and targeted women. Ninety-seven percent of the interventions were aimed at increasing community demand, 65% community access and 11% provider delivery. Our findings suggest that 21 of the 37 interventions using a multicomponent approach were effective in increasing breast, cervical and colorectal cancer screening in rural areas. Conclusions: Multicomponent interventions were effective in increasing breast, cervical and colorectal cancer screening among rural populations, and nurse-led interventions contributed to improving cancer screening participation. Moreover, the involvement of communities in the development of interventions can facilitate the participation in cancer screening programs among rural residents. (C) 2019 Elsevier Ltd. All rights reserved.