title: Methods to increase participation in organised screening programs: a systematic review.
abstract: BACKGROUND
  The European Community recommends the implementation of population-based screening programmes for cervical, breast, and colorectal cancers. This recommendation is supported by many observational studies showing that organised programmes effectively reduce mortality and control the inappropriate use of screening tests. We conducted a systematic review of studies assessing the efficacy of interventions to increase participation in organised population-based screening programs.
  
  
  METHODS
  We included all studies on interventions aimed at increasing screening participation published between 1/1999 and 7/2012. For those published before 1999, we considered the Jepson et al. (2000) review (Health Technol Assess 4:1-133, 2000).
  
  
  RESULTS
  Including studies from the Jepson review, we found 69 with quantitative information on interventions in organised screening: 19 for cervical, 26 for breast, 20 colorectal cancers, and 4 for cervical and breast cancer together.Effective interventions were: postal (breast RR = 1,37 95% Confidence Interval (95% CI): 1.25-1.51; cervical RR = 1.71 95% CI: 1.60-1.83; colorectal RR = 1.33 95% CI: 1.17-1.51) and telephone reminders (with heterogeneous methods for implementation); GP's signature on invitation letter (breast RR = 1.13 95% CI: 1.11-1.16; cervical RR = 1.20 95% CI: 1.10-1.30; colorectal RR = 1.15 95% CI: 1.07-1.24); scheduled appointment instead of open appointment (breast RR = 1.26 95% CI: 1.02-1.55; cervical RR = 1.49 95% CI: 1.27-1.75; colorectal RR = 1.79 95% CI: 1.65-1.93). Mailing a kit for self-sampling cervical specimens increased participation in non-responders (RR = 2.37 95% CI: 1.44-3.90).
  
  
  CONCLUSIONS
  Although some interventions did prove to be effective, some specific variables may influence their effectiveness in and applicability to organised population-based screening programs.
authors.affiliation: Laziosanità – Agency for Public Health, Lazio Region, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Camilloni
authors.forename: Eliana
authors.initials: E
authors.lastname: Ferroni
authors.forename: Beatriz Jimenez
authors.initials: BJ
authors.lastname: Cendales
authors.forename: Annamaria
authors.initials: A
authors.lastname: Pezzarossi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Furnari
authors.forename: Piero
authors.initials: P
authors.lastname: Borgia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Guasticchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D005060:Europe; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D017010:Reminder Systems; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control