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Cancer Screening: Reducing Structural Barriers 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., 2 studies, search period 1966-2004) combined with more recent evidence (1 study, 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: Reducing Structural Barriers – Cervical Cancer pdf icon [PDF - 248 KB].

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 153 KB].

Three studies qualified for the review.

  • Pap screening: median increase of 13.6 percentage points (range: 5.9 – 17.8)
  • While these results were in the favorable direction, the studies had some methodological limitations.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

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 interventions to reduce structural barriers to increase breast, cervical, or colorectal cancer screening.

  • Are interventions effective for promoting colorectal cancer screening with methods other than FOBT?
  • Are interventions to promote colorectal cancer screening equally effective when addressing colorectal cancer screening more generally, as when specific to one type of test?
  • 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?

Study Characteristics

  • One study examined a nurse-led clinic within a correctional facility, one offered onsite screening to residents at a high-rise apartment building, and one invited participants to receive screening during extended hours.
  • Studies were conducted in the U.S., Canada, and Australia.

Publications