Reducing socio-economic inequalities in bowel cancer screening: a systematic review of intervention strategies amongst deprived communities.

Abstract

Background: Uptake of bowel cancer screening in the United Kingdom is sub-optimal and a socio-economic gradient evident. This review aimed to identify and assess the effectiveness of interventions designed to increase screening participation in deprived communities.

Methods: A narrative systematic review of UK literature (2000-2025) was conducted using CINAHL Plus, Embase, Medline, PsycINFO, and Scopus. Studies were included if they evaluated interventions specifically targeting bowel cancer screening uptake and explicitly reported on effectiveness amongst populations living in deprived communities/areas.

Results: From 5534 articles, nine met the inclusion criteria. Evidence directly focused on deprived communities was limited, and inconsistent quality of evidence precluded strong recommendations for practice. Nonetheless, the available findings suggest that targeted telephone calls, face-to-face consultations, enhanced written communications, and multi-component approaches increase screening uptake in underserved populations.

Conclusions: Further research is needed to clarify decision-making processes, identify optimal intervention timing, and understand mechanisms that drive effectiveness in deprived groups. Future interventions should be co-designed with individuals from deprived communities to ensure relevance, acceptability, and potential to reduce socio-economic inequalities in bowel cancer screening participation.