筛查可以减少结直肠癌（CRC）的发病率和死亡率，但在美国的接受程度仍不理想。以往的研究已经探讨了各种干预措施对整体CRC筛查和基于大便的检测的影响，但对于美国主要的筛查测试-结肠镜的影响尚未得到充分的研究。我们进行了一项系统回顾和荟萃分析，以评估行为干预对筛查结肠镜接受率的影响。我们通过2022年1月在PubMed、EMBASE和Cochrane数据库中搜索了有关评估行为干预对筛查结肠镜接受率影响的对照试验。所有标题、摘要和文章均由至少两名独立的评价者进行筛选。在原始文章中提取或从原始数据计算了比值比。主要结果是任何行为干预对筛查结肠镜完成率的相对提高。我们进行了随机效应荟萃分析，并通过干预类型进行了亚组分析。共分析了25项研究及30种行为干预。最常见的干预措施是对病患进行导航（n=11）和多组分干预（n=6）。总体而言，行为干预使结肠镜完成率增加了54％，相比之下（OR 1.54，95％CI 1.26-1.88）。在多个研究中，与其他干预措施相比，对于结肠镜完成率的影响，病患导航（OR 1.78，95％CI 1.35-2.34）和多组分干预（OR 1.84，95％CI 1.17-2.89）效果最强。整体和根据干预类型观察到了显著的异质性。没有证据表明出版偏见。行为干预可以增加筛查结肠镜的完成率，应该在临床实践中采用。特别是，病患导航和多组分干预是研究最充分和最有效的干预措施。 Copyright © 2023 by The American College of Gastroenterology.

Screening decreases colorectal cancer (CRC) incidence and mortality, but uptake in the United States remains suboptimal. Prior studies have investigated the effect of various interventions on overall CRC screening and stool-based testing, but the effect on colonoscopy-the predominant screening test in the US-has not been fully examined. We performed a systematic review and meta-analysis to assess the effect of behavioral interventions on screening colonoscopy uptake.We searched PubMed, EMBASE, and Cochrane databases through January 2022 for controlled trials that assessed the effect of behavioral interventions on screening colonoscopy uptake. All titles, abstracts, and articles were screened by at least two independent reviewers. Odds ratios were extracted from the original article or calculated from the raw data. The primary outcome was the relative increase in screening colonoscopy completion with any behavioral intervention. We performed random effects meta-analysis, with subgroup analysis by type of intervention.A total of 25 studies with 30 behavioral interventions were analyzed. The most common interventions were patient navigation (n=11) and multi-component interventions (n=6). Overall, behavioral interventions increased colonoscopy completion by 54% compared to controls (OR 1.54, 95% CI 1.26-1.88). Patient navigation (OR 1.78, 95% CI 1.35-2.34) and multi-component interventions (OR 1.84, 95% CI 1.17-2.89) had the strongest effect on colonoscopy completion among interventions examined in multiple studies. Significant heterogeneity was observed both overall and by intervention type. There was no evidence of publication bias.Behavioral interventions increase screening colonoscopy completion and should be adopted in clinical practice. In particular, patient navigation and multi-component interventions are the best-studied and most effective interventions.Copyright © 2023 by The American College of Gastroenterology.