title: Community-based cancer screening programs in older populations: making progress but can we do better?
abstract: BACKGROUND
  Older individuals have higher rates of most types of cancer. Community-based cancer screening programs offer one avenue for addressing the need to prevent or detect cancers in early stages in this population. Identifying characteristics of successful interventions can assist researchers in the development of future studies.
  
  
  METHODS
  A comprehensive literature review of community-based cancer screening interventions was undertaken and 114 behavioral interventions for breast, cervical and colorectal cancer screening published prior to 2000 and 42 studies published during 2000-2003 were identified. From these, 17 studies were identified as model interventions that were effective in significantly increasing screening rates among older populations.
  
  
  RESULTS
  Effective interventions employed a variety of strategies including the use of social networks and lay health care workers, mass media, community-based education, reminder notices/behavioral cues, and health care provider assistance.
  
  
  CONCLUSIONS
  Although subgroups of individuals still have lower rates of screening, the results indicate that older populations can be encouraged to engage in appropriate cancer screening behaviors through community-based interventions. The next round of interventions could be strengthened by evaluating intervention components, integrating theory and community participation into designs, focusing on those most at need, and considering program sustainability and costs.
authors.affiliation: Social and Behavioral Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. bcurbow@jhsph.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Curbow
authors.forename: Janice
authors.initials: J
authors.lastname: Bowie
authors.forename: Mary A
authors.initials: MA
authors.lastname: Garza
authors.forename: Karen
authors.initials: K
authors.lastname: McDonnell
authors.forename: Lisa Benz
authors.initials: LB
authors.lastname: Scott
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Coyne
authors.forename: Ted
authors.initials: T
authors.lastname: Chiappelli
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003153:Community Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*