Faculty Advisor

Margaret Harvey, PhD, APRN, ACNP-BC, CHFN

Subject Matter Expert

Colorectal Cancer

Clinical Site

University of Tennessee Health Science Center: College of Nursing

Document Type


Publication Date

Spring 5-1-2023


Investigative Techniques | Medicine and Health Sciences | Nursing



Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance.


Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of the modality of CRC screening, patient compliance, and patient education was assessed and compared. A summary evaluation table was composed to determine the associations between CRC screening and patient compliance.


The articles included consisted of four systematic reviews/meta-analysis, three randomized controlled trials, one controlled trial without randomization, and two cohort/case-control studies. Of the study sample (N=10), all but one demonstrated statistically significant findings concerning patient education, CRC screening, and compliance. Noninvasive stool-based studies have a higher patient compliance rate than direct visualization tests. Direct visualization tests offer same-session detection and biopsy with polyp removal leading to decreased mortality.

Implications for Nursing Practice

Results provided in this scoping review highlight the importance of colorectal cancer screening in decreasing mortality. Patient compliance can be improved with comprehensive education, discussing the risks and benefits of screenings, and evaluating individual health beliefs or fears. Patients still hesitant with direct visualization tests should begin with noninvasive studies. All positive screenings from stool-based screenings require follow-up with a colonoscopy.