Community Health Workers to Increase Cancer Screening: 3 Community Guide Systematic Reviews

• Published in: American journal of preventive medicine 2023-04, Vol.64 (4), p.579-594
• Main Authors: Okasako-Schmucker, Devon L., Peng, Yinan, Cobb, Jamaicia, Buchanan, Leigh R., Xiong, Ka Zang, Mercer, Shawna L., Sabatino, Susan A., Melillo, Stephanie, Remington, Patrick L., Kumanyika, Shiriki K., Glenn, Beth, Breslau, Erica S., Escoffery, Cam, Fernandez, Maria E., Coronado, Gloria D., Glanz, Karen, Mullen, Patricia D., Vernon, Sally W.
• Format: Article
• Language: English
• Subjects: Community Health Workers; Early Detection of Cancer; Humans; Income; Neoplasms; Preventive Health Services
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2022.10.016

Many in the U.S. are not up to date with cancer screening. This systematic review examined the effectiveness of interventions engaging community health workers to increase breast, cervical, and colorectal cancer screening. Authors identified relevant publications from previous Community Guide systematic reviews of interventions to increase cancer screening (1966 through 2013) and from an update search (January 2014–November 2021). Studies written in English and published in peer-reviewed journals were included if they assessed interventions implemented in high-income countries; reported screening for breast, cervical, or colorectal cancer; and engaged community health workers to implement part or all of the interventions. Community health workers needed to come from or have close knowledge of the intervention community. The review included 76 studies. Interventions engaging community health workers increased screening use for breast (median increase=11.5 percentage points, interquartile interval=5.5‒23.5), cervical (median increase=12.8 percentage points, interquartile interval=6.4‒21.0), and colorectal cancers (median increase=10.5 percentage points, interquartile interval=4.5‒17.5). Interventions were effective whether community health workers worked alone or as part of a team. Interventions increased cancer screening independent of race or ethnicity, income, or insurance status. Interventions engaging community health workers are recommended by the Community Preventive Services Task Force to increase cancer screening. These interventions are typically implemented in communities where people are underserved to improve health and can enhance health equity. Further training and financial support for community health workers should be considered to increase cancer screening uptake.