Colorectal cancer (CRC) is the second leading cause of cancerrelated death worldwide [1]. CRC is amenable to early detection with earlier diagnosis improving prognosis [2-4]. Like many regions around the world, Canadian provincial screening programs use fecal occult blood tests (FOBTs)-guaiac or immunochemical, depending on the province-as the initial CRC screening test [5]. When FOBTs are positive (FOBT+), colonoscopy is required for a definitive CRC diagnosis [6]. Delays in obtaining follow-up colonoscopy increase the risk of CRC, including advanced-stage disease [7, 8], while non-adherence considerably increases the risk of CRC death [9]. Timely receipt of follow-up colonoscopy is therefore critical to reducing the burden of CRC at the population level. Colon Cancer Check (CCC) is Ontario's organized CRC screening program and Canada's largest CRC screening program, serving just over 4 million eligible individuals [6]. CCC recommends biennial guaiac FOBT (Hema-Screen, Immunostics Inc., NJ, USA) for persons ages 50-74 at average CRC risk [10]. Primary care providers (PCPs) facilitate screening by dispensing FOBT kits, receiving test results and arranging follow-up colonoscopy for persons with FOBT + results. While a follow-up colonoscopy rate of 85-90%
Background
Cancer is a leading cause of death, and although screening can reduce cancer morbidity and mortality, participation in screening remains suboptimal.
Objective
This systematic review and meta-analysis aims to evaluate the effectiveness of social media and mobile health (mHealth) interventions for cancer screening.
Methods
We searched for randomized controlled trials and quasi-experimental studies of social media and mHealth interventions promoting cancer screening (breast, cervical, colorectal, lung, and prostate cancers) in adults in MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, and Communication & Mass Media Complete from January 1, 2000, to July 17, 2020. Two independent reviewers screened the titles, abstracts, and full-text articles and completed the risk of bias assessments. We pooled odds ratios for screening participation using the Mantel-Haenszel method in a random-effects model.
Results
We screened 18,008 records identifying 39 studies (35 mHealth and 4 social media). The types of interventions included peer support (n=1), education or awareness (n=6), reminders (n=13), or mixed (n=19). The overall pooled odds ratio was 1.49 (95% CI 1.31-1.70), with similar effect sizes across cancer types.
Conclusions
Screening programs should consider mHealth interventions because of their promising role in promoting cancer screening participation. Given the limited number of studies identified, further research is needed for social media interventions.
Trial Registration
PROSPERO International Prospective Register of Systematic Reviews CRD42019139615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139615
International Registered Report Identifier (IRRID)
RR2-10.1136/bmjopen-2019-035411
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.