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Cancer > Cancer Screening > Provider Reminders
Provider-oriented Cancer Screening Interventions: Provider Reminders
The Task Force on Community Preventive Services recommends provider reminder systems based on evidence of their effectiveness in increasing:
- breast cancer screening by mammography
- cervical cancer screening by Pap test, and
- colorectal cancer screening by fecal occult blood test (FOBT) and flexible sigmoidoscopy.
The Task Force concluded there was insufficient evidence to determine the effectiveness of using provider reminders to increase:
- colorectal cancer screening by colonoscopy or double contrast barium enema.
These findings were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to the topic of interest.
- Provider reminder/recall systems (provider reminders) inform health care providers that patients or clients are:
- due (reminder), or
- overdue (recall) for specific cancer screening tests.
- Reminders may be:
- generated electronically or manually
- delivered in client charts, by computer, mail, other means, or noted in client charts to initiate in-person discussion, and
- can vary in format and content (notation, flow chart, electronic message, or checklist).
- Reminders can occur before, during, or after a scheduled visit.
Findings from the Systematic Review
Twenty-five studies qualified for the review and included 2 outcome measures.
- The included studies had thirty-one estimates of the effect of provider reminders on the screening outcomes of interest: 12 for mammography, 13 for Pap tests, five for FOBTs, and one for flexible sigmoidoscopy.
- All effects (with one exception) on mammography, Pap test, and FOBT completion were in the positive direction, with an 8.8 percentage point median increase across these tests.
- There was a median increase of 12 percentage points in the proportion of study participants who completed mammography.
- There was a median increase of 4.7 percentage points in the proportion of study participants who completed Pap tests.
- There was a median increase of 17.6 percentage points in the proportion of study participants who completed FOBTs and flexible sigmoidoscopy.
The review team and the Task Force on Community Preventive Services attempt to address key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps". Research gaps are pulled together in the form of a basic set of questions to inform a research agenda for those in the field. Each completed Community Guide review includes a section on research gaps (or issues), which is included in the full evidence review in the
Library once published.
Cancer is a major public health problem in the United States. For more information on the scope of this problem, visit
Background on Screening for Breast, Cervical and Colorectal Cancers.
Evidence Review:
Sabatino SA, Habarta N, Baron RC. Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers: systematic reviews of provider assessment and feedback and provider incentives. Am J Prev Med 2008;35(1S):67-74.
Recommendations:
Task Force on Community Preventive Services. Recommendations for client- and provider-directed interventions to increase breast, cervical, and colorectal cancer screening Am J Prev Med 2008;35(1S):21-5.
The findings and conclusions in this report are those of the authors and the Task Force on Community Preventive Services and do not necessarily represent the official position of the CDC.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Provider-oriented cancer screening interventions: provider reminders. www.thecommunityguide.org/cancer/screening/provider-reminders.htm.
Last Updated: MM/DD/YYYY.
Review completed: July 2008
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