Closing the disparity gap: Cancer screening interventions among Asians – A systematic literature review

Background: Asians have high mortality rates for most type of cancers. Many of them also fail to adhere to the current guidelines for breast, cervical and colorectal cancer screenings. Although interventions have been developed to increase screening, the effectiveness of different types of interventions is unclear. Methods: Electronic databases were searched from January 1995 and December 2009. A comprehensive literature review of interventions was undertaken and interventions for breast, cervical and colorectal cancer screening among Asians, including Vietnamese, Koreans, Chinese and Taiwanese, Thais, Asians, Cambodians, Filipina, and a mixed group of Thai, Cambodian, Filipina and Chinese were included. Results: Thirty studies were reviewed to identify characteristics of interventions and program effectiveness. The studies included were diverse in terms of design, target population, theoretical underpinning of intervention approach and outcome measures. Effective interventions employed a variety of strategies including the use of social networks, lay health workers, mass media, community based education, reminder notices, health care provider assistance and health care system changes. Fifteen studies utilized behavioral theories in intervention development. Conclusion: This review finds that Asian populations can be encouraged to engage in appropriate cancer screening behaviors through community-based and lay health worker strategies. Selections of intervention strategies will depend on the characteristics of the target group and feasibility of implementation. Challenges and recommendations for tailored screening interventions for Asians are discussed.