Interventions targeted at women to encourage the uptake of cervical screening

Cochrane Review by Forbes C, Jepson R, Martin-Hirsch P

This record should be cited as: Forbes C, Jepson R, Martin-Hirsch P. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD002834. DOI: 10.1002/14651858.CD002834.

ABSTRACT

Title

Interventions targeted at women to encourage the uptake of cervical screening

Background

Cervical cancer is the third most common cancer world-wide. Increasing the uptake of screening, alongside increasing informed choice is of great importance in controlling this disease through prevention and early detection.

Objectives

To assess the effectiveness of interventions aimed at increasing uptake, and informed uptake of cervical cancer screening.

Search strategy

Twenty-three electronic databases (to March 2000) were searched with no language restrictions.

Selection criteria

Randomised controlled trials (RCTs), or quasi-RCTs of interventions to increase uptake/informed uptake of cervical cancer screening.

Data collection and analysis

Data on study characteristics and quality were extracted independently by two reviewers. Where data were available, relative risks and 95% CI were calculated and a chi-squared test for heterogeneity was performed.

Main results

Thirty-five studies were included (27 RCTs and eight quasi-RCTs). Heterogeneity between studies limited statistical pooling of data. Overall, however, invitations appear to be effective methods of increasing uptake. In addition, there is limited evidence to support the use of educational materials. The number and quality of included studies limited evidence regarding effectiveness of other interventions. Informed uptake of cervical screening was not considered by any studies.

Authors' conclusions

There was some evidence to support the use of invitation letters to increase the uptake of cervical screening. There was limited evidence to support educational interventions but it was unclear what format was most effective. The majority of the studies were from developed countries and so the relevance to developing countries is unclear.

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