IDDF2022-ABS-0228 How effective are digital technology-based interventions at promoting colorectal cancer screening uptake in average-risk populations? A systematic review and meta-analysis of randomized controlled trials

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Background Despite the global prevalence of colorectal cancer (CRC) and efforts in screening advocacy, screening uptake remains relatively low across countries. Considering the greater accessibility and popularity of telemedicine in behaviour change interventions, this meta-analysis seeks to examine the usefulness of digital interventions in promoting CRC screening uptake as compared to existing non-digital strategies. Methods A systematic search on five databases identified articles published before August 2020. Randomised controlled trials comparing the effectiveness of digital interventions to usual care were included and assessed using the Cochrane’s Risk of Bias tool. The effectiveness of interventions was measured by CRC screening completion rates, and pooled effect sizes were computed for both digital intervention subtypes identified – decision-making aids and tailored educational interventions. Results Twelve studies (12,189 participants) assessed to have low or some risk of bias were included in this meta-analysis. A random-effects model revealed that digital interventions were more likely to promote CRC screening uptake (OR=1.30, 95% CI: 1.07–1.58), and using a decision-making aid was almost 1.5 times more likely to result in screening completion (OR=1.44, 95% CI: 1.20–1.72). Meanwhile, the tailored educational intervention subtype failed to achieve statistical significance in promoting screening uptake, likely attributed to the significant heterogeneity across studies (I2=89.8%). Conclusions Digital decision-making aids, significantly improved CRC screening uptake compared to tailored digital educational interventions and usual care. However, the potential role of decision-making aids in augmenting existing CRC screening promotion strategies should be further evaluated in terms of cost-effectiveness and efficacy rates, especially within an Asian context.

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