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Cancer Screening: One-on-One Education for Clients – Cervical Cancer

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review published in 2008 (Baron et al., 5 studies, search period 1966-2004) combined with more recent evidence (0 studies, search period 2004-2008). The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to cancer prevention and control. This finding updates and replaces the 2008 CPSTF finding on Cancer Screening: One-On-One Education - Cervical Cancer pdf icon [PDF - 338 KB].

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 155 KB].

Five studies, with 8 study arms, were included in the original systematic review.

  • Completed Pap tests: median increase of 8.1 percentage points (interquartile interval: 5.7 to 17.3 percentage points; 8 study arms)

No additional studies were identified during this update.

Summary of Economic Evidence

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 155 KB].

The updated search for evidence included nine studies about breast cancer (5 studies), cervical cancer (1 study), or colorectal cancer (3 studies) screening. Monetary values are presented in 2009 U.S dollars.

  • Of the nine included studies, eight reported results from actual interventions and one used economic modeling.
    • The cost per additional screening ranged from $39 to $5,306, with a median of $534.
    • The most expensive intervention was the most resource intensive. Lay health advisors conducted three in-person home visits, made follow-up phone calls, and sent mailings that addressed barriers to screening.

Applicability

Tailored and untailored one-on-one education interventions to increase cervical cancer screening should be applicable across a range of settings and populations, provided they are adapted and targeted for a specific population and delivery context.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

The following outlines evidence gaps for one-on-one education to increase breast, cervical, or colorectal cancer screening.

  • What duration, dose, and intensity of one-on-one educational interventions are needed to be effective (Baron et al., 2008)?
  • What characteristics of "tailoring" contribute to its effect? Are there effects of tailoring channels (personal interaction, anonymous interaction)?
  • Does effectiveness of one-on-one education interventions vary according to whether or not education is delivered by a medical professional?
  • What are the incremental effects of adding intervention components to other interventions?
  • What influence do newer methods of communication (e.g., the Internet, e-mail, social media, automated interactive voice response, texting) have on intervention effectiveness?
  • What is the influence of health system factors on intervention effectiveness?
  • Are interventions effective for promoting colorectal cancer screening with methods other than FOBT?
  • Are interventions to promote colorectal cancer screening equally effective when specific to one type of test as they are when addressing colorectal cancer screening more generally?

Study Characteristics

No qualifying studies were identified during the updated search period.

Publications