African American cultureRESEARCH ARTICLE

Interventions for increasing colorectal cancer

screening uptake among African-American

men: A systematic review and meta-analysis

Charles R. RogersID
1*, Phung Matthews1, Lei Xu2, Kenneth Boucher3, Colin Riley1,

Matthew Huntington1, Nathan Le Duc1, Kola S. Okuyemi1, Margaret J. Foster4

1 Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah,

United States of America, 2 Department of Health Education and Promotion, East Carolina University,

Greenville, NC, United States of America, 3 Cancer Biostatistics Shared Resource, Huntsman Cancer

Institute, Salt Lake City, UT, United States of America, 4 Medical Sciences Library, Texas A&M University,

College Station, TX, United States of America




African-American men have the lowest 5-year survival rate in the U.S. for colorectal cancer

(CRC) of any racial group, which may partly stem from low screening adherence. It is imper-

ative to synthesize the literature evaluating the effectiveness of interventions on CRC

screening uptake in this population.

Materials and methods

In this systematic review and meta-analysis, Medline, CINAHL, Embase, and Cochrane

CENTRAL were searched for U.S.-based interventions that: were published after 1998–

January 2020; included African-American men; and evaluated CRC screening uptake

explicitly. Checklist by Cochrane Collaboration and Joanna Brigg were utilized to assess

risk of bias, and meta-regression and sensitivity analyses were employed to identify the

most effective interventions.


Our final sample comprised 41 studies with 2 focused exclusively on African-American men.

The most frequently adopted interventions were educational materials (39%), stool-based

screening kits (14%), and patient navigation (11%). Most randomized controlled trials failed

to provide details about the blinding of the participant recruitment method, allocation con-

cealment method, and/or the outcome assessment. Due to high heterogeneity, meta-analy-

sis was conducted among 17 eligible studies. Interventions utilizing stool-based kits or

patient navigation were most effective at increasing CRC screening completion, with odds

ratios of 9.60 (95% CI 2.89–31.82, p = 0.0002) and 2.84 (95% CI 1.23–6.49, p = 0.01). No

evidence of publication bias was present for this study registered with the International Pro-

spective Registry of Systematic Reviews (PROSPERO 2019 CRD42019119510).


PLOS ONE | September 16, 2020 1 / 27







Citation: Rogers CR, Matthews P, Xu L, Boucher K,

Riley C, Huntington M, et al. (2020) Interventions

for increasing colorectal cancer screening uptake

among African-American men: A systematic review

and meta-analysis. PLoS ONE 15(9): e0238354.

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