Effectiveness of tailored talks between a cancer screening specialist and general practitioners to improve the uptake of colorectal cancer screening in Ancona (Italy) during the pandemic period

Abstract

Background

Colorectal cancer (CRC) screening uptake in many countries has been low and further impacted by the COVID-19 pandemic. General Practitioners (GPs) are key facilitators, however research on their impact on organised CRC screening is still limited.

Objectives

To evaluate the effectiveness of tailored talks with GPs to increase population uptake of the long-established CRC screening programme in Ancona province, Italy.

Methods

In this prospective cohort study, one-to-one tailored talks were organised in January 2020 between the GPs of one county of the province (with GPs from other counties as controls) and the screening programme physician-in-chief to discuss the deployment and effectiveness of organised screening. Data was extracted from the National Healthcare System datasets and linear regression was used to assess the potential predictors of CRC screening uptake.

Results

The mean CRC screening uptake remained stable from 39.9% in 2018–19 to 40.8% in 2020–21 in the 22 GPs of the intervention county, whereas it statistically significantly decreased from 38.7% to 34.7% in the 232 control GPs. In multivariate analyses, belonging to the intervention county was associated with an improved uptake compared to the control counties (+5.1%; 95% Confidence Intervals – CI: 2.0%; 8.1%).

Conclusion

Persons cared for by GPs who received a tailored talk with a cancer screening specialist avoided a drop in CRC screening adherence, which characterised all other Italian screening programmes during the COVID-19 emergency. If future randomised trials confirm the impact of tailored talks, they may be incorporated into existing strategies to improve population CRC screening uptake.

KEY MESSAGES

• Tailored talks on CRC screening were conducted between one cancer screening specialist and GPs.

• Even during the pandemic, CRC screening uptake was stable among persons cared for by GPs targeted by tailored talks.

• If confirmed by randomised trials, tailored talks may be employed to improve CRC screening uptake.

Keywords:

• Colorectal cancer
• cancer screening
• general practice
• Italy

Authors contributions

CAM: conceptualisation and methodology; GG: investigation; CAM and MEF: formal analysis; CAM, MaM, SR, SB, LP, MU: data curation; GG, LM, and FP: supervision and validation; CAM and MoM: writing – original draft; MEF, LM, MP, and FP: writing – review and editing. All authors critically revised the article for important intellectual content and gave final approval. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Data availability statement

All data is available from the corresponding author upon reasonable request.