This is a protocol of a systematic review

Foster, Margaret

Huntington, Matt

Okuyemi, Kola

Riley, Colin

Rogers, Charles

English

Texas A&M University

 PROSPERO
International prospective register of systematic reviews
 Interventions for increasing colorectal cancer screening uptake among African-American
men: a systematic review and meta-analysis
Charles R. Rogers, Colin Riley, Matt Huntington, Margaret Foster, Kola S. Okuyemi
 
Citation
Charles R. Rogers, Colin Riley, Matt Huntington, Margaret Foster, Kola S. Okuyemi. Interventions
for increasing colorectal cancer screening uptake among African-American men: a systematic
review and meta-analysis. PROSPERO 2019 CRD42019119510 Available from: 
http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019119510
 
Review question
We will employ systematic review of the literature, along with a quantitative meta-analysis with three goals:
1) synthesize the evidence from published studies evaluating interventions to increase CRC screening
uptake among African-American men; 2) assess the methodological quality of this evidence; and 3)
quantitatively assess the evidence from these published studies through meta-analysis in order to determine
the most effective screening uptake interventions for African-American men. 
 
Searches
The following databases were searched from 11/2/18 to 12/14/18: MEDLINE (Ovid), CINAHL (EBSCO) ,
Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley). The concepts were
colorectal cancer, screening, African American, and men. Both thesaurus terms and keywords were
searched for each concept. After 1998
 
Types of study to be included
Studies which are empirical and use primary data analysis and collection are included in the meta-analysis
and systematic review. Furthermore, these studies must highlight the intervention performed and an analysis
of the intervention's effectiveness. Literature reviews, meta-analysis, or studies which use data from a
secondary source will not be included in the meta-analysis and systematic review.
 
Condition or domain being studied
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the U.S. and the second leading
cause of cancer related deaths. African-American men are disproportionately impacted by CRC,
experiencing the lowest five-year survival rate of any other demographic group and are 27% more likely of
having CRC as compared to white men. It is well documented that CRC screening is a highly effective
preventive measure against the disease, yet screening uptake remains low among African-American men.
 
Participants/population
The population of interest for this meta-analysis and systematic review is African-American men in the U.S.
The study population is not limited by educational attainment level, socioeconomic status, or other criteria.
Interventions which only target women, race/ethnicity not including African Americans, or are conducted in
countries outside of the United States, were excluded.
 
Intervention(s), exposure(s)
Interventions aimed at increasing CRC screening vary greatly, and many of which will be discovered through
the systematic review process. Potential interventions include: providing patients with printed educational
materials, providing patient care navigation services, conducting phone calls to encourage and remind
patients about screening, accessing common community events/happenings (church, fairs, barbershops,
etc.) and promoting CRC screening, mailing appointment reminders and or educational materials, promoting
CRC screening education via primary care physicians, or hosting group educational meetings.
 
Comparator(s)/control
Examined studies may compare two interventions against one another or compare an intervention against no
intervention. Control or comparison groups, where used, are samples taken from the same or similar
                               Page: 1 / 4
 PROSPERO
International prospective register of systematic reviews
populations.
 
Context
Exclusion criteria includes: (1) study focus (about CRCscreening uptake/completion), (2) a primary, empirical
study, (3) published in 1998 or beyond; (4) conducted in the U.S., (5) language of the article/study (English),
(6) study sample includes African-American men; (7) whether an intervention/trial was described, and (8)
whether an intervention/trial was evaluated. 
 
Main outcome(s)
The primary outcomes of this meta-analysis and systematic review is to determine the effectiveness of CRC
uptake interventions. Studies will be defined effective if they provide statistically significant evidence that an
intervention has increased the number of African-American men who have received CRC screening (CRCS)
when compared to average CRCS uptake among the same population. Studies which lack evidence of
statistically significant improved CRCS rates will also be useful in determining the best method for increasing
CRCS among African-American men. Consequently, studies that will be included in this meta-analysis and
systematic review must provide details of the intervention used and whether it was evaluated.
Timing and effect measures
 
Additional outcome(s)
None
Timing and effect measures
 
Data extraction (selection and coding)
Studies are screened by using the Rayyan software, with a total of 966 articles were identified for initial
screening. Exclusion criteria includes: study focus (about colorectal cancer screening), study design, date
published (>1997), study location (performed in the U.S.), language of the article/study (English),
race/ethnicity of study population (African American), whether an intervention was performed, and whether
an evaluation of the intervention was performed. After initial screening is complete, a full text selection will be
completed.
 
Risk of bias (quality) assessment
To establish the reliability of the methodological quality scoring (MQS) processes and data abstraction, 25%
of the studies will be randomly selected and assigned to two reviewers. The risk of bias tool will stem from a
modification of previous MQS tool published by the first author. Percent agreement will be calculated;
reviewers will discuss their disagreements, and consensus will be achieved prior to assigning the final MQS.
 
Strategy for data synthesis
After the full text screening data will be extracted according to study characteristics, sample population
characteristics, findings, and limitations. Where applicable, effect sizes will be calculated for each included
study. Effect sizes will be grouped by intervention type in an effort to determine the impact of different types
of interventions on the outcome under observation. A synthesized effect size will then be calculated for each
intervention group. The synthesized effect sizes will allow for comparison between intervention type.
 
Analysis of subgroups or subsets
Based on current trends, CRC incidence rates among those ages 20-34 are predicted to increase 90%-124%
by 2030, and 28%-46% among Americans ages 35-49. Further, the American Cancer Society updated their
guidelines for recommended CRC screening from age 50 to age 45 on May 30, 2018, in direct response to
the increase in incidence of early age onset CRC. Accordingly, the research team will see which
interventions included African-American men younger than age 50.
 
Contact details for further information
Dr. Charles R. Rogers
                               Page: 2 / 4
 PROSPERO
International prospective register of systematic reviews
charles.rogers@utah.edu
 
Organisational affiliation of the review
University of Utah School of Medicine
https://medicine.utah.edu/dfpm/
 
Review team members and their organisational affiliations
Dr Charles R. Rogers. University of Utah
Mr Colin Riley. University of Utah
Mr Matt Huntington. University of Utah
Mrs Margaret Foster. Texas A&M University
Dr Kola S. Okuyemi. University of Utah
 
Anticipated or actual start date
20 September 2018
 
Anticipated completion date
31 May 2019
 
Funding sources/sponsors
Research reported in this publication was supported by the National Cancer Institute of the National
Institutes of Health under Award Number K01CA234319. The content is solely the responsibility of the
authors and does not necessarily represent the official views of the National Institutes of Health.
 
Conflicts of interest
 
Language
English
 
Country
United States of America
 
Stage of review
Review_Ongoing
 
Subject index terms status
Subject indexing assigned by CRD
 
Subject index terms
Colorectal Neoplasms; Early Detection of Cancer; Humans; Male; United States
 
Date of registration in PROSPERO
01 February 2019
 
Date of publication of this version
01 February 2019
 
Details of any existing review of the same topic by the same authors
 
Stage of review at time of this submission
                               Page: 3 / 4
 PROSPERO
International prospective register of systematic reviews
 Stage Started Completed
Preliminary searches Yes No
Piloting of the study selection process Yes No
Formal screening of search results against eligibility criteria Yes No
Data extraction No No
Risk of bias (quality) assessment No No
Data analysis No No
 
Versions
01 February 2019
PROSPERO
This information has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration
record, any associated files or external websites. 
Powered by TCPDF (www.tcpdf.org)
                               Page: 4 / 4


Interventions for increasing colorectal cancer screening uptake among African-American men: a systematic review and meta-analysis

Texas A&amp;M Repository

 PROSPEROInternational prospective register of systematic reviews Interventions for increasing colorectal cancer screening uptake among African-Americanmen: a systematic review and meta-analysisCharles R. Rogers, Colin Riley, Matt Huntington, Margaret Foster, Kola S. Okuyemi CitationCharles R. Rogers, Colin Riley, Matt Huntington, Margaret Foster, Kola S. Okuyemi. Interventionsfor increasing colorectal cancer screening uptake among African-American men: a systematicreview and meta-analysis. PROSPERO 2019 CRD42019119510 Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019119510 Review questionWe will employ systematic review of the literature, along with a quantitative meta-analysis with three goals:1) synthesize the evidence from published studies evaluating interventions to increase CRC screeninguptake among African-American men; 2) assess the methodological quality of this evidence; and 3)quantitatively assess the evidence from these published studies through meta-analysis in order to determinethe most effective screening uptake interventions for African-American men.  SearchesThe following databases were searched from 11/2/18 to 12/14/18: MEDLINE (Ovid), CINAHL (EBSCO) ,Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley). The concepts werecolorectal cancer, screening, African American, and men. Both thesaurus terms and keywords weresearched for each concept. After 1998 Types of study to be includedStudies which are empirical and use primary data analysis and collection are included in the meta-analysisand systematic review. Furthermore, these studies must highlight the intervention performed and an analysisof the intervention's effectiveness. Literature reviews, meta-analysis, or studies which use data from asecondary source will not be included in the meta-analysis and systematic review. Condition or domain being studiedColorectal cancer (CRC) is the third most commonly diagnosed cancer in the U.S. and the second leadingcause of cancer related deaths. African-American men are disproportionately impacted by CRC,experiencing the lowest five-year survival rate of any other demographic group and are 27% more likely ofhaving CRC as compared to white men. It is well documented that CRC screening is a highly effectivepreventive measure against the disease, yet screening uptake remains low among African-American men. Participants/populationThe population of interest for this meta-analysis and systematic review is African-American men in the U.S.The study population is not limited by educational attainment level, socioeconomic status, or other criteria.Interventions which only target women, race/ethnicity not including African Americans, or are conducted incountries outside of the United States, were excluded. Intervention(s), exposure(s)Interventions aimed at increasing CRC screening vary greatly, and many of which will be discovered throughthe systematic review process. Potential interventions include: providing patients with printed educationalmaterials, providing patient care navigation services, conducting phone calls to encourage and remindpatients about screening, accessing common community events/happenings (church, fairs, barbershops,etc.) and promoting CRC screening, mailing appointment reminders and or educational materials, promotingCRC screening education via primary care physicians, or hosting group educational meetings. Comparator(s)/controlExamined studies may compare two interventions against one another or compare an intervention against nointervention. Control or comparison groups, where used, are samples taken from the same or similar                               Page: 1 / 4 PROSPEROInternational prospective register of systematic reviewspopulations. ContextExclusion criteria includes: (1) study focus (about CRCscreening uptake/completion), (2) a primary, empiricalstudy, (3) published in 1998 or beyond; (4) conducted in the U.S., (5) language of the article/study (English),(6) study sample includes African-American men; (7) whether an intervention/trial was described, and (8)whether an intervention/trial was evaluated.  Main outcome(s)The primary outcomes of this meta-analysis and systematic review is to determine the effectiveness of CRCuptake interventions. Studies will be defined effective if they provide statistically significant evidence that anintervention has increased the number of African-American men who have received CRC screening (CRCS)when compared to average CRCS uptake among the same population. Studies which lack evidence ofstatistically significant improved CRCS rates will also be useful in determining the best method for increasingCRCS among African-American men. Consequently, studies that will be included in this meta-analysis andsystematic review must provide details of the intervention used and whether it was evaluated.Timing and effect measures Additional outcome(s)NoneTiming and effect measures Data extraction (selection and coding)Studies are screened by using the Rayyan software, with a total of 966 articles were identified for initialscreening. Exclusion criteria includes: study focus (about colorectal cancer screening), study design, datepublished (>1997), study location (performed in the U.S.), language of the article/study (English),race/ethnicity of study population (African American), whether an intervention was performed, and whetheran evaluation of the intervention was performed. After initial screening is complete, a full text selection will becompleted. Risk of bias (quality) assessmentTo establish the reliability of the methodological quality scoring (MQS) processes and data abstraction, 25%of the studies will be randomly selected and assigned to two reviewers. The risk of bias tool will stem from amodification of previous MQS tool published by the first author. Percent agreement will be calculated;reviewers will discuss their disagreements, and consensus will be achieved prior to assigning the final MQS. Strategy for data synthesisAfter the full text screening data will be extracted according to study characteristics, sample populationcharacteristics, findings, and limitations. Where applicable, effect sizes will be calculated for each includedstudy. Effect sizes will be grouped by intervention type in an effort to determine the impact of different typesof interventions on the outcome under observation. A synthesized effect size will then be calculated for eachintervention group. The synthesized effect sizes will allow for comparison between intervention type. Analysis of subgroups or subsetsBased on current trends, CRC incidence rates among those ages 20-34 are predicted to increase 90%-124%by 2030, and 28%-46% among Americans ages 35-49. Further, the American Cancer Society updated theirguidelines for recommended CRC screening from age 50 to age 45 on May 30, 2018, in direct response tothe increase in incidence of early age onset CRC. Accordingly, the research team will see whichinterventions included African-American men younger than age 50. Contact details for further informationDr. Charles R. Rogers                               Page: 2 / 4 PROSPEROInternational prospective register of systematic reviewscharles.rogers@utah.edu Organisational affiliation of the reviewUniversity of Utah School of Medicinehttps://medicine.utah.edu/dfpm/ Review team members and their organisational affiliationsDr Charles R. Rogers. University of UtahMr Colin Riley. University of UtahMr Matt Huntington. University of UtahMrs Margaret Foster. Texas A&M UniversityDr Kola S. Okuyemi. University of Utah Anticipated or actual start date20 September 2018 Anticipated completion date31 May 2019 Funding sources/sponsorsResearch reported in this publication was supported by the National Cancer Institute of the NationalInstitutes of Health under Award Number K01CA234319. The content is solely the responsibility of theauthors and does not necessarily represent the official views of the National Institutes of Health. Conflicts of interest LanguageEnglish CountryUnited States of America Stage of reviewReview_Ongoing Subject index terms statusSubject indexing assigned by CRD Subject index termsColorectal Neoplasms; Early Detection of Cancer; Humans; Male; United States Date of registration in PROSPERO01 February 2019 Date of publication of this version01 February 2019 Details of any existing review of the same topic by the same authors Stage of review at time of this submission                               Page: 3 / 4 PROSPEROInternational prospective register of systematic reviews Stage Started CompletedPreliminary searches Yes NoPiloting of the study selection process Yes NoFormal screening of search results against eligibility criteria Yes NoData extraction No NoRisk of bias (quality) assessment No NoData analysis No No Versions01 February 2019PROSPEROThis information has been provided by the named contact for this review. CRD has accepted this information in goodfaith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registrationrecord, any associated files or external websites. Powered by TCPDF (www.tcpdf.org)                               Page: 4 / 4

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Interventions for increasing colorectal cancer screening uptake among African-American men: a systematic review and meta-analysis

Abstract

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Interventions for increasing colorectal cancer screening uptake among African-American men: a systematic review and meta-analysis

Abstract

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Full text

Available Versions

Texas A&M University

Texas A&amp;M Repository

Texas A&M Repository