Behavioral Interventions Have a Large Impact on Colonoscopy Uptake

Behavioral Interventions Have a Large Impact on Colonoscopy Uptake

Douglas K. Rex, MD, MASGE, reviewing Yakoubovitch S, et al. Am J Gastroenterol 2023 Aug 22.

Twenty-five studies with 30 interventions were analyzed for this study on the effect of behavioral interventions on colonoscopy uptake. Of the interventions evaluated by the studies, 3 used mailed letters, 3 used informational brochures, 11 were patient navigation, one was a preprocedural telephone consult, one was primary care provider counseling, 2 were videos, one was a change in electronic health record settings, one was an email intervention, one used a financial incentive, and 6 studies evaluated multiple interventions.

The overall increase in colonoscopy uptake by interventions was significant at 54%, with patient navigation at 78% and multicomponent interventions at 84% having the strongest impact. The single study on telephone intervention resulted in a 13% decline in colonoscopy uptake. When studies involving low-income or racial minority groups were excluded, the impact of interventions increased.

Douglas K. Rex, MD, FASGE


Certainly, different behavioral interventions are needed for different populations, and navigation of the colonoscopy process has proven very valuable in socioeconomically disadvantaged groups. These results indicate that a variety of behavioral interventions can have a substantial and important impact on colonoscopy uptake across many populations.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Yakoubovitch S, Zaki T, Anand S, Pecoriello J, Liang PS. Effect of behavioral interventions on the uptake of colonoscopy for colorectal cancer screening: a systematic review and meta-analysis. Am J Gastroenterol 2023 Aug 22. (Epub ahead of print) (

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