Abstract PO-268: Evaluating the effects of compliance on screening uptake: A literature review
Authors: Hoang Theresa , Korslin Michelle , Lang Kathryn , Raymond Victoria M. 
Published: December 2020

Background: Screening and prevention can lead to early diagnosis and treatment resulting in improvements in patient outcomes. Several professional societies, namely the United States Preventative Services Task Force (USPSTF), have created clinical guidelines advocating for screening and prevention in specific disease states. Despite the proven positive impacts of guideline recommendations, patient compliance remains low, especially in medically underserved communities. We aimed to understand the impact of screening modality on patient compliance.

Methods: USPSTF average-risk adult screening guidelines were reviewed. For diseases with multiple screening options, a targeted literature review was completed, exploring the published data on screening methods, compliance rates, and outcomes. Results: Of the eight USPSTF-reviewed disease states, colorectal cancer (CRC), breast, prostate, lung, and cervical cancers, osteoporosis, HIV, and syphilis, six had multiple screening modalities available. Three of six disease states (cervical cancer, CRC, and HIV) had screening options with variable modes of delivery, including office testing, at-home collection, and blood tests. With implementation of alternative screening options, there exists published evidence of increased compliance to screening recommendations; in cervical cancer, the availability of home collection kits as an alternative to traditional in-office screening increased compliance by 5.6% -30%. In CRC, the availability of stool-based screening and blood-based screening as an alternative to colonoscopy improved compliance by 5.8-61%, and in HIV, the availability of home self-testing kits not only improved the testing rate by 49.8%, but also general awareness of testing, as 33.1% of study participants reported distributing self-testing kits to their social networks without prompting from study investigators. Among most commonly cited reasons for improved compliance were convenience, privacy, and ease of access. Patient choice in selecting the most convenient screening intervention when multiple screening options or modes of delivery were available was considered to contribute highly to improved compliance. Conclusion: Based on a review of the current USPSTF screening guidelines and associated literature, patient choice and the availability of screening options with multiple delivery modes play important roles in screening compliance. This underscores the importance of shared decision making in screening and prevention discussions, especially around the risks, benefits, and limitations of screening options.

Citation Format: Theresa Hoang, Michelle Korslin, Kathryn Lang, Victoria M. Raymond. Evaluating the effects of compliance on screening uptake: A literature review [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-268.