Table 3.
Impact of Interventions Engaging CHWs on Breast, Cervical, and Colorectal Cancer Screening
| Cancer type/ Screening test/ Effect of CHW | Citations | Median (IQI) |
|---|---|---|
| Breast cancer | ||
| Mammography | ||
| Overall (42 study arms) | 32, 34–39, 42, 43, 47–49, 52–56, 60, 62–64, 71, 75, 76, 78, 80, 83, 85, 87–93, 95, 104, 106 | Median increase of 11.5 percentage points (IQI: 5.5 to 23.5) |
| CHW alone (21 study arms) | 35, 39, 43, 47, 49, 52, 54, 55, 62, 71, 75, 76, 78, 83, 85, 88, 89, 91, 95, 104 | Median increase of 9.2 percentage points (IQI: 4.7 to 22.8) |
| CHW added (6 study arms) | 32, 34, 43, 48, 60, 80 | Median increase of 11.0 percentage points (IQI: 2.3 to 13.5) |
| CHW in a team (17 study arms) | 34, 36–38, 42, 43, 48, 53, 55, 56, 63, 64, 87, 92, 93, 106 | Median increase of 13.7 percentage points (IQI: 9.1 to 29.7) |
| Cervical cancer | ||
| Pap test | ||
| Overall (31 study arms) | 36, 38, 39, 41, 47, 49, 51, 52, 56, 68, 72, 73, 77, 78, 81, 83, 84, 86, 87, 93–100, 103, 104, 106, 107 | Median increase of 12.8 percentage points (IQI: 6.4 to 21.0) |
| CHW alone (18 study arms) | 39, 41, 47, 49, 52, 72, 73, 78, 83, 84, 86, 95, 96, 99, 100, 103, 104, 107 | Median increase of 13.7 percentage points (IQI: 7.6 to 20.2) |
| CHW added (3 study arms) | 68, 77, 94 | Median increase of 11.0 percentage points (Range: 6.4 to 16.8) |
| CHW in a team (10 study arms) | 36, 38, 51, 56, 81, 87, 93, 97, 98, 106 | Median increase of 15.4 percentage points (IQI: 3.0 to 34.0) |
| Colorectal cancer | ||
| Colonoscopy, FOBT/FIT, or sigmoidoscopy | ||
| Overall (25 study arms) | 33, 36, 39, 40, 44, 45, 49, 53, 58, 61, 62, 65, 66, 69, 70, 74, 79, 82, 101, 102, 104, 105 | Median increase of 10.5 percentage points (IQI: 4.5 to 17.5) |
| CHW alone (15 study arms) | 33, 39, 40, 45, 49, 61, 62, 66, 70, 79, 82, 101, 104 | Median increase of 10.5 percentage points (IQI: 4.0 to 13.0) |
| CHW added (4 study arms) | 44, 102, 105 | Median increase of 6.5 percentage points (IQI: 5.1 to 29.7) |
| CHW in a team (8 study arms) | 33, 40, 45, 58, 62, 74, 93, 96, 104, 107 | Median increase of 16.1 percentage points (IQI: 4.4 to 27.3) |
| Colonoscopy | ||
| CHW alone (7 study arms) | 39, 61, 62, 70, 104 | Median increase of 10.5 percentage points (IQI: 7.1 to 13.0) |
| FOBT/FIT | ||
| Overall (17 study arms) | 39, 40, 44, 45, 49, 58, 61, 62, 66, 70, 101, 102, 104, 105 | Median increase of 7.8 percentage points (IQI: 5.2 to 16.5) |
| CHW alone (12 study arms) | 39, 40, 45, 49, 61, 62, 66, 70, 101, 104 | Median increase of 7.7 percentage points (IQI: 3.7 to 17.9) |
| CHW added (4 study arms) | 44, 102, 105 | Median increase of 6.8 percentage points (IQI: 5.1 to 29.8) |
| CHW in a team (3 study arms) | 44, 58, 102 | Median increase of 13.5 percentage points (Range: 12.5 to 28.6) |
| Sigmoidoscopy | ||
| CHW alone (5 study arms) | 61, 62, 104 | Median increase of 3.5 percentage points (IQI: −2.3, 58.5) |
| Colonoscopy or sigmoidoscopy | ||
| CHW alone (4 study arms) | 45, 49, 66, 101 | Median increase of 6.6 percentage points (IQI: 4.3, 8.2) |
CHW, community health worker; FIT, fecal immunochemical test; FOBT, fecal occult blood test; IQI, interquartile interval; pct pts, percentage points.