Equity-focused interventions to increase colorectal cancer screening

Tailored, equity-based approaches are key to increasing colorectal screening rates

To be effective, efforts to increase colorectal cancer screening rates must consider health equity. They should be co-created, tailored and adapted with communities to address their specific needs (particularly low-income households, immigrants and people living in remote and rural areas) because no single approach has been found to be effective for all groups.

The following key findings should be considered when developing new approaches to increasing screening rates among underscreened populations:

  • Screening uptake improves when health providers actively recommend screening to their participants and work to enhance the participants’ health literacy.
  • Multi-component interventions that combine several different strategies—with patient navigation being a particularly effective strategy among others—are a proven, effective approach for increasing screening rates among diverse population groups.
  • The single interventions with the most evidence for effectiveness across diverse populations are participant reminders, small media, reduced structural barriers and one-on-one education. These can also be used as part of multicomponent interventions.


To improve colorectal cancer screening rates across Canada, health system leaders and decision-makers should:

icon pin on mapEngage local communities and collect local-level data to create detailed profiles of specific populations. These can help determine which interventions are most effective among these groups. Ideally, interventions should be co-created with communities and fully integrated into organized cancer screening programs.

The Canadian Strategy for Cancer Control

These recommendations support the Strategy, which calls for system-level changes to improve how services are adapted to the specific needs of different population groups, practical research to gain a better understanding of barriers, and training to enable cancer care providers to deliver culturally appropriate care to all participants.

icon magnifying glassConduct more research to better understand the barriers, facilitators and optimal approaches to increasing screening uptake among population groups that experience inequities. These groups include those with disabilities and chronic diseases, LGBTQ2S+, and houseless and transient individuals.

icon First Nations, Inuit and MétisCollaborate with First Nations, Inuit and Métis communities to develop effective, Peoples-specific approaches, grounded in reconciliation, for increasing uptake of colorectal screening.

icon phoneLook for and adopt innovative new solutions, such as using technology to provide electronic reminders for screening or to offer participant and provider education via an interactive electronic platform.

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