Twenty-one studies (n=36,347) were included in the review. Twenty studies were RCTs.
Patient-level interventions (15 studies): Interventions to eliminate structural barriers (provision of faecal occult blood tests for use at home; five studies) and those that focused on one-to-one interactions (counselling using non-physician staff; three studies) showed increased screening rates from 15% to 42%. Patient reminders were associated with small to moderate increases in screening rates (5% to 15%). Study quality was graded as high. There was no statistically significant increase or mixed evidence in support of small media with or without decision aids and group education.
Health care system interventions (five studies): Increased screening rates of between 7% and 28% were found across all studies that assessed system-level interventions. Study quality was graded as high.
Provider-level interventions (two studies): Letters provided as physician reminders were associated with a 5% increase in surveillance follow up (one study). Study quality was graded as low.
There was limited evidence (one RCT) to support increased incidence of colorectal cancer screening discussions between patients and health professionals following a multi-component intervention.