Early awareness interventions for cancer: colorectal cancer

Research on interventions to increase early detection of CRC (through patient awareness campaigns to increase self-presentation or to increase screening attendance) show generally positive results at all stages of the logic model. However, there is only a small amount of evidence towards the end of the logic model, and the available evidence throughout is not of high quality due to study design (mostly before-after studies), and a potentially high risk of bias. It was not possible to draw comparative conclusions between interventions or which components of interventions conferred the positive effects. There is a lack of evidence to inform the link between increased self-presentation and screening attendance to earlier detection of CRC, though it should be noted that all evidence relating to this came from the US.

The data available from the ‘signs and symptoms’ pilot campaign which was used in the cost-effectiveness modelling was associated with limitations and considerable uncertainty. A priority for future research is to co-ordinate and maximise the evaluation and dissemination of efforts that have already been made to increase CRC awareness. For example, clear reporting of completeness of data, and comparison with non-intervention regions are important. To establish the potential effectiveness and cost-effectiveness of such a campaign, information on ‘duration of effect of campaign’, ‘effect of campaign on CRC incidence’ and ‘effect of campaign by age’ are of importance.