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Intervention Review

Interventions targeted at women to encourage the uptake of cervical screening

  1. Carol A Forbes1,*,
  2. Ruth G Jepson2,
  3. Pierre PL Martin-Hirsch3

Editorial Group: Cochrane Gynaecological Cancer Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 14 MAY 2002

DOI: 10.1002/14651858.CD002834

Database Title

Additional Information

How to Cite

Forbes CA, Jepson RG, Martin-Hirsch PPL. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD002834. DOI: 10.1002/14651858.CD002834.

Author Information

  1. 1

    University of York, NHS Centre for Reviews & Dissemination, York, North Yorkshire, UK

  2. 2

    University of Stirling, Department of Nursing and Midwifery, Stirling, Scotland, UK

  3. 3

    Royal Preston Hospital, Lancashire Teaching Hospital NHS Trust, Gynaecological Oncology Unit, Preston, Lancashire, UK

*Carol A Forbes, NHS Centre for Reviews & Dissemination, University of York, Heslington, York, North Yorkshire, YO10 5DD, UK. caf4@york.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

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  2. Abstract
  3. Plain language summary

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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Invitations and probably educational interventions increase the uptake of Pap smears

Methods of encouraging women to undergo cervical screening - invitations, reminders, education, message framing, counselling, risk factor assessment, procedures and economic interventions were looked at in this review. Evidence supports the use of invitations, and to a lesser extent, educational materials. It is likely other methods are advantageous, but the evidence is not as strong. Further research is required.

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