Systematic review of the determinants of screening uptake and interventions for increasing uptake

Jepson R, Clegg A, Forbes C, Lewis R, Sowden A, Kleijnen J
Record ID 32000000882
Authors' objectives:

To carry out a systematic review to examine factors associated with the uptake of screening programmes and to assess the effectiveness of methods used to increase uptake.

In particular, the following questions were addressed:

- What factors (i.e. determinants) were associated with uptake of screening for different diseases? - What interventions were shown to increase uptake of screening programmes (or informed uptake) within populations?

Authors' recommendations: The authors identified a number of implications for practice arising from this review, and it is important to consider the findings in two ways: in relation to actual uptake and in relation to informed uptake. Any attempts to increase the uptake of screening should be pursued alongside initiatives to increase informed uptake. Individuals who previously participated in screening were more likely to be screened subsequently. Efforts could be focused on identifying and encouraging attendance among those who have never previously participated in screening. Current practice in the UK national screening programmes using invitation letters and/or appointments is supported by good evidence. Invitation telephone calls could also be considered, although the cost-effectiveness of this approach remains uncertain in the UK. All of these approaches could be considered for other screening tests. Reducing economic barriers (e.g. offering free postage or transportation costs) can increase uptake and may be appropriate for specific groups. Telephone counselling where barriers to screening are discussed could be considered. Healthcare professionals can be prompted either to perform or to recommend screening tests by using reminder systems such as tagged notes. Such reminder systems could be considered in secondary as well as primary care.
Authors' methods: Systematic review
Project Status: Completed
URL for project:
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Mass Screening
  • Patient Acceptance of Health Care
  • Neoplasms
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
Contact Email:
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.