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Interventions to improve the uptake of cervical cancer screening among lower socioeconomic groups: A systematic review

Rees et al. (2017)

Health Evidence - 10.1016/j.ypmed.2017.11.019

Evidence Categories

  • Care setting: Any setting
  • Population group: Women
  • Population group: Low socioeconomic status
  • Intervention: Any intervention
  • Outcome: Screening: Uptake of cervical cancer screening

Type of Evidence

Systematic Review

Aims

Cervical cancer is the fourth most common cancer in women worldwide. Screening can reduce both the incidence and mortality of the disease but is often not utilized by lower socioeconomic groups. A systematic review, including studies of interventions to improve breast and cervical cancer screening uptake, up to 2006, found targeted interventions could be effective. A formal update has been conducted on the effectiveness of interventions to improve the uptake of cervical cancer screening among lower socioeconomic groups.

Findings

This update yielded 16 studies of mixed quality, in addition to the 13 studies from the original review. The interventions were categorized into local interventions including HPV self-testing, lay health advisors, inreach, outreach and mixed, and strategies enhancing attendance within an organized program. This review has found two large, randomized controlled trials for the use of HPV self-testing to increase cervical screening uptake. Both reviews have found varying success using lay health advisors, with the majority of included papers reporting a statistically significant increase in screening uptake.

Conclusions

HPV self-testing can improve uptake of cervical cancer screening among lower socioeconomic groups. This is a relatively new method of cervical screening that was not included in the earlier review. The findings of this updated review largely support that of the 2006 review for the use of lay health advisors.