From participation to diagnostic assessment: a systematic scoping review of the role of the primary healthcare sector in the National Bowel Cancer Screening Program
Carol A. Holden A F , Oliver Frank B , Joanna Caruso A , Deborah Turnbull C , Richard L. Reed D , Caroline L. Miller A E and Ian Olver C
+ Author Affiliations
- Author Affiliations
A South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia.
B Discipline of General Practice, University of Adelaide, Helen Mayo North, Frome Road, Adelaide, SA 5005, Australia.
C School of Psychology, University of Adelaide, Level 7, Hughes Building, North Terrace Campus, Adelaide, SA 5000, Australia.
D College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
E School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
F Corresponding author. Email: carol.holden@sahmri.com
Australian Journal of Primary Health 26(3) 191-206 https://doi.org/10.1071/PY19181
Submitted: 18 September 2019 Accepted: 7 January 2020 Published: 15 June 2020
Journal Compilation © La Trobe University 2020 Open Access CC BY-NC-ND
Abstract
Primary health care (PHC) plays a vital support role in organised colorectal cancer (CRC) screening programs by encouraging patient participation and ensuring timely referral for diagnostic assessment follow up. A systematic scoping review of the current evidence was conducted to inform strategies that better engage the PHC sector in organised CRC screening programs. Articles published from 2005 to November 2019 were searched across five databases. Evidence was synthesised and interventions that specifically require PHC involvement were mapped to stages of the CRC screening pathway. Fifty-seven unique studies were identified in which patient, provider and system-level interventions align with defined stages of the CRC screening pathway: namely, identifying/reminding patients who have not responded to CRC screening (non-adherence) (n = 46) and follow up of a positive screen referral (n = 11). Self-management support initiatives (patient level) and improvement initiatives (system level) demonstrate consistent benefits along the CRC screening pathway. Interventions evaluated as part of a quality-improvement process tended to report effectiveness; however, the variation in reporting makes it difficult to determine which elements contributed to the overall study outcomes. To maximise the benefits of population-based screening programs, better integration into existing primary care services can be achieved through targeting preventive and quality care interventions along the entire screening pathway.
Additional keywords: preventive medicine, quality of health care, secondary prevention.
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