Investigating interventions for increasing colorectal cancer screening: Insights from a simulation model

We develop a discrete-event-continuous simulation model of colorectal cancer screening in North Carolina to examine the impact of six different interventions on the fraction of eligible patients receiving the clinically recommended screening. We find that demand side interventions alone are less effective than using only supply side interventions or a combination of both; the single most effective intervention is implementing a patient reminder system to reduce the number of no-show patients; and that all interventions studied are subject to significant diminishing returns.

► We tested six interventions designed to raise the rate of screening for colon cancer in North Carolina.
► All interventions are subject to diminishing returns to scale.
► Interactions between interventions lead to equilibrium behavior of the fraction of population screened.
► Best results are obtained by combining supply-side and demand-side interventions.
► The single most effective intervention is the use of a patient reminder system to reduce no-show rates.