The U.S. Preventive Services Task Force (USPSTF) makes recommendations based on evidence of a net benefit of specific preventive clinical services on health outcomes in a general primary care population. The “pathway to benefit” for cancer screenings depends on high-quality standardized screening programs, appropriate follow-up for timely diagnosis, and effective treatment. The USPSTF states:
- To achieve the benefit of screening and mitigate disparities in breast cancer mortality by race and ethnicity, it is important that all persons with abnormal screening mammography results receive equitable and appropriate follow-up evaluation and additional testing, inclusive of indicated biopsies, and that all persons diagnosed with breast cancer receive effective treatment.
- Although low screening rates contribute to high mortality rates in certain underserved populations, screening alone is not sufficient to reduce cervical cancer morbidity and mortality and related disparities. Loss to follow-up and disparities in treatment are also contributing factors. Therefore, having systems in place to ensure follow-up of abnormal results, appropriate treatment of any pathology, and support to retain patients throughout the entirety of cancer treatment are important.
- Maintaining comparable benefits and harms of [colorectal cancer] screening with the various strategies requires that patients, clinicians, and health care organizations adhere to currently recommended protocols for screening intervals, follow-up colonoscopy, and treatment.
- The randomized clinical trials that provide evidence for the benefit of screening for lung cancer with LDCT were primarily conducted in academic centers with expertise in the performance and interpretation of LDCT and the management of lung lesions seen on LDCT [i.e., standardization of LDCT screening and follow-up of abnormal findings] .
The following meta-analyses and systematic reviews inform the interventions selected for inclusion on EBCCP:
- Impact of patient navigation on timely cancer care: the Patient Navigation Research Program
- The impact of patient navigation on the delivery of diagnostic breast cancer care in the National Patient Navigation Research Program: a prospective meta-analysis
- The efficacy and cost-effectiveness of patient navigation programs across the cancer continuum: A systematic review
- Interventions to increase follow-up of abnormal cervical cancer screening results: A systematic literature review and meta-analysis
- Evaluation of Interventions Intended to Increase Colorectal Cancer Screening Rates in the United States: A Systematic Review and Meta-analysis
Additional evidence can be found in Cancer Trends Progress Report: Stage at Diagnosis.