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Meta-Analysis
. 2021 Sep 6;9(9):CD002834.
doi: 10.1002/14651858.CD002834.pub3.

Interventions targeted at women to encourage the uptake of cervical screening

Helen Staley  1 , Aslam Shiraz  2 , Norman Shreeve  3 , Andrew Bryant  4 , Pierre Pl Martin-Hirsch  5 , Ketankumar Gajjar  6
Affiliations
Meta-Analysis

Interventions targeted at women to encourage the uptake of cervical screening

Helen Staley et al. Cochrane Database Syst Rev. .

Abstract

Background: This is an update of the Cochrane review published in Issue 5, 2011. Worldwide, cervical cancer is the fourth commonest cancer affecting women. High-risk human papillomavirus (HPV) infection is causative in 99.7% of cases. Other risk factors include smoking, multiple sexual partners, the presence of other sexually transmitted diseases and immunosuppression. Primary prevention strategies for cervical cancer focus on reducing HPV infection via vaccination and data suggest that this has the potential to prevent nearly 90% of cases in those vaccinated prior to HPV exposure. However, not all countries can afford vaccination programmes and, worryingly, uptake in many countries has been extremely poor. Secondary prevention, through screening programmes, will remain critical to reducing cervical cancer, especially in unvaccinated women or those vaccinated later in adolescence. This includes screening for the detection of pre-cancerous cells, as well as high-risk HPV. In the UK, since the introduction of the Cervical Screening Programme in 1988, the associated mortality rate from cervical cancer has fallen. However, worldwide, there is great variation between countries in both coverage and uptake of screening. In some countries, national screening programmes are available whereas in others, screening is provided on an opportunistic basis. Additionally, there are differences within countries in uptake dependent on ethnic origin, age, education and socioeconomic status. Thus, understanding and incorporating these factors in screening programmes can increase the uptake of screening. This, together with vaccination, can lead to cervical cancer becoming a rare disease.

Objectives: To assess the effectiveness of interventions aimed at women, to increase the uptake, including informed uptake, of cervical screening.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 6, 2020. MEDLINE, Embase and LILACS databases up to June 2020. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field.

Selection criteria: Randomised controlled trials (RCTs) of interventions to increase uptake/informed uptake of cervical screening.

Data collection and analysis: Two review authors independently extracted data and assessed risk of bias. Where possible, the data were synthesised in a meta-analysis using standard Cochrane methodology.

Main results: Comprehensive literature searches identified 2597 records; of these, 70 met our inclusion criteria, of which 69 trials (257,899 participants) were entered into a meta-analysis. The studies assessed the effectiveness of invitational and educational interventions, lay health worker involvement, counselling and risk factor assessment. Clinical and statistical heterogeneity between trials limited statistical pooling of data. Overall, there was moderate-certainty evidence to suggest that invitations appear to be an effective method of increasing uptake compared to control (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.49 to 1.96; 141,391 participants; 24 studies). Additional analyses, ranging from low to moderate-certainty evidence, suggested that invitations that were personalised, i.e. personal invitation, GP invitation letter or letter with a fixed appointment, appeared to be more successful. More specifically, there was very low-certainty evidence to support the use of GP invitation letters as compared to other authority sources' invitation letters within two RCTs, one RCT assessing 86 participants (RR 1.69 95% CI 0.75 to 3.82) and another, showing a modest benefit, included over 4000 participants (RR 1.13, 95 % CI 1.05 to 1.21). Low-certainty evidence favoured personalised invitations (telephone call, face-to-face or targeted letters) as compared to standard invitation letters (RR 1.32, 95 % CI 1.11 to 1.21; 27,663 participants; 5 studies). There was moderate-certainty evidence to support a letter with a fixed appointment to attend, as compared to a letter with an open invitation to make an appointment (RR 1.61, 95 % CI 1.48 to 1.75; 5742 participants; 5 studies). Low-certainty evidence supported the use of educational materials (RR 1.35, 95% CI 1.18 to 1.54; 63,415 participants; 13 studies) and lay health worker involvement (RR 2.30, 95% CI 1.44 to 3.65; 4330 participants; 11 studies). Other less widely reported interventions included counselling, risk factor assessment, access to a health promotion nurse, photo comic book, intensive recruitment and message framing. It was difficult to deduce any meaningful conclusions from these interventions due to sparse data and low-certainty evidence. However, having access to a health promotion nurse and attempts at intensive recruitment may have increased uptake. One trial reported an economic outcome and randomised 3124 participants within a national screening programme to either receive the standard screening invitation, which would incur a fee, or an invitation offering screening free of charge. No difference in the uptake at 90 days was found (574/1562 intervention versus 612/1562 control, (RR 0.94, 95% CI: 0.86 to 1.03). The use of HPV self-testing as an alternative to conventional screening may also be effective at increasing uptake and this will be covered in a subsequent review. Secondary outcomes, including cost data, were incompletely documented. The majority of cluster-RCTs did not account for clustering or adequately report the number of clusters in the trial in order to estimate the design effect, so we did not selectively adjust the trials. It is unlikely that reporting of these trials would impact the overall conclusions and robustness of the results. Of the meta-analyses that could be performed, there was considerable statistical heterogeneity, and this should be borne in mind when interpreting these findings. Given this and the low to moderate evidence, further research may change these findings. The risk of bias in the majority of trials was unclear, and a number of trials suffered from methodological problems and inadequate reporting. We downgraded the certainty of evidence because of an unclear or high risk of bias with regards to allocation concealment, blinding, incomplete outcome data and other biases.

Authors' conclusions: There is moderate-certainty evidence to support the use of invitation letters to increase the uptake of cervical screening. Low-certainty evidence showed lay health worker involvement amongst ethnic minority populations may increase screening coverage, and there was also support for educational interventions, but it is unclear what format is most effective. The majority of the studies were from developed countries and so the relevance of low- and middle-income countries (LMICs), is unclear. Overall, the low-certainty evidence that was identified makes it difficult to infer as to which interventions were best, with exception of invitational interventions, where there appeared to be more reliable evidence.

PubMed Disclaimer

Conflict of interest statement

Helen Staley ‐ none known Aslam Shiraz ‐ none known Norman Shreeve ‐ none known Andrew Bryant ‐ none known Pierre PL Martin‐Hirsch ‐ none known Ketankumar Gajjar ‐ none known

Figures

1
1
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
4
4
Funnel plot of comparison: 1 Invitation vs control, outcome: 1.1 Uptake of screening
1.1
1.1. Analysis
Comparison 1: Invitation versus control, Outcome 1: Uptake of screening
2.1
2.1. Analysis
Comparison 2: GP invitation letter versus invitation letter from other authority sources, Outcome 1: Uptake of screening
3.1
3.1. Analysis
Comparison 3: Personal invitation versus invitation letter, Outcome 1: Uptake of screening
4.1
4.1. Analysis
Comparison 4: Letter with fixed appointment versus letter with open invitation to make an appointment, Outcome 1: Uptake of screening
5.1
5.1. Analysis
Comparison 5: Counselling versus control, Outcome 1: Uptake of screening
6.1
6.1. Analysis
Comparison 6: Counselling versus other, Outcome 1: Uptake of screening
7.1
7.1. Analysis
Comparison 7: Education versus control, Outcome 1: Uptake of screening
7.2
7.2. Analysis
Comparison 7: Education versus control, Outcome 2: Lay health outreach worker vs control
8.1
8.1. Analysis
Comparison 8: Education versus other, Outcome 1: Lay health outreach worker and media education vs media education
8.2
8.2. Analysis
Comparison 8: Education versus other, Outcome 2: Uptake of screening
8.3
8.3. Analysis
Comparison 8: Education versus other, Outcome 3: Individual education vs social support group
9.1
9.1. Analysis
Comparison 9: Enhanced risk assessment versus control, Outcome 1: Uptake of screening
10.1
10.1. Analysis
Comparison 10: Enhanced risk assessment versus other, Outcome 1: Uptake of screening
11.1
11.1. Analysis
Comparison 11: Access to health promotion nurse versus control, Outcome 1: Uptake of screening
12.1
12.1. Analysis
Comparison 12: Photo comic versus placebo comic, Outcome 1: Uptake of screening
13.1
13.1. Analysis
Comparison 13: Intensive recruitment attempts versus control, Outcome 1: Uptake of screening
14.1
14.1. Analysis
Comparison 14: Message framing, Outcome 1: Gain versus loss message framing (detection)
14.2
14.2. Analysis
Comparison 14: Message framing, Outcome 2: Gain versus loss message framing (prevention)
14.3
14.3. Analysis
Comparison 14: Message framing, Outcome 3: Gain message framing: prevention vs detection
14.4
14.4. Analysis
Comparison 14: Message framing, Outcome 4: Loss message framing: prevention vs detection
15.1
15.1. Analysis
Comparison 15: Economic: free screening test versus standard fee, Outcome 1: Uptake of screening
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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References to studies excluded from this review

Abdullah 2013b {published data only}
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Acera 2014 {published data only}
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    1. Atlas SJ, Ashburner JM, Zai A, Chang Y, Percac-Lima S, Levy D, et al. Non-visit-based cancer screening using a novel population management system. Journal of the American Noard of Family Medicine 2014;27(4):474-85. - PubMed
Baele 1998 {published data only}
    1. Baele J. The influence of a home-visit on the participation of Moroccan and Spanish women in cervical cancer screening: an intervention study [De invloed van een huisbezoek op de participatie van Marokkaanse en Spaanse vrouwen aan een bevolkigsonderzoek naar baarmoederhalskanker in Vlaams-Brabant. Een interventiestudie]. Tijdschrift voor Sociale Gezondheidszorg 1998;76:374-80.
Bebis 2012 {published data only}
    1. Bebis H, Reis N, Yayan T, Bayrak D, Unal A, Bodur S. Effect of health education about cervical cancer and papanicolaou testing on behaviour, knowledge, and beliefs of Turkish women. International Journal of Gynaecological Cancer 2012;22(8):1407-12. - PubMed
Benard 2014 {published data only}
    1. Benard VB, Saraiya M, Greek A, Hawkins NA, Roland KB, Manninen D, et al. Overview of the CDC cervical cancer (Cx3) study: an educational intervention of HPV testing for cervical cancer screening. Journal of Womens Health 2014;23(3):197-203. - PMC - PubMed
Blomberg 2011 {published data only}
    1. Blomberg K, Tishelman C, Ternestedt BM, Tornberg S, Leval A, Widmark C. How can young women be encouraged to attend cervical cancer screening? Suggestions from face-to-face and internet focus group discussions with 30-year-old women in Stockholm, Sweden. Acta Oncologica 2011;50(1):112-20. - PubMed
Boissel 1995 {published data only}
    1. Boissel JP, Collet JP, Alborini A, Cordel JC, Filsnoel J, Gillet J, et al. Education program for general practitioners on breast and cervical cancer screening: a randomized trial. PRE.SA.GF Collaborative Group. Revue D'Epidémiologie et De Santé Publique 1995;43(6):541-7. - PubMed
Bonevski 1999 {published data only}
    1. Bonevski B, Sanson-Fisher RW, Campbell E, Carruthers A, Reid AL, Ireland M. Randomized controlled trial of a computer strategy to increase general practitioner preventive care. Preventive Medicine 1999;29(6 Pt 1):478-86. - PubMed
Brewster 2002 {published data only}
    1. Brewster WR, Anton Culver H, Ziogas A, Largent J, Howe S, Hubbell FA, et al. Recruitment strategies for cervical cancer prevention study. Gynecologic Oncology 2002;85(2):250-4. - PubMed
Broberg 2012 {published data only}
    1. Broberg G, Jonasson JM, Ellis J, Anjemark B, Glantz A, Soderberg L, et al. Increasing participation in cervical cancer screening: telephone call to long time abstaining women in Sweden. Results from RACOMIP, a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2012;91:72-3.
Broberg 2014 {published data only}
    1. Broberg G, Gyrd-Hansen D, Jonasson JM, Ryd M, Holtenman M, Milsom I, et al. Increasing participation in cervical cancer screening: Offering a HPV self-test to long-term non-attendees as part of RACOMIP, a Swedish randomized controlled trial. International Journal of Cancer 2014;134:2223-30. - PubMed
Burger 2017 {published data only}
    1. Burger EA, Sy S, Nygard M, Kim JJ. The cost-effectiveness of cervical self-sampling to improve routine cervical cancer screening: the importance of respondent screening history and compliance. Cancer Epidemiology, Biomarkers & Prevention 2017;26(1):95-103. - PMC - PubMed
Cadman 2015 {published data only}
    1. Cadman L, Wilkes S, Mansour D, Austin J, Ashdown-Barr L, Edwards R, et al. A randomized controlled trial in non-responders from Newcastle upon Tyne invited to return a self-sample for human papillomavirus testing versus repeat invitation for cervical screening. Journal of Medical Screening 2015;22:28-37. - PubMed
Campbell 1997 {published data only}
    1. Campbell E, Peterkin D, Abbott R, Rogers J. Encouraging underscreened women to have cervical cancer screening: the effectiveness of a computer strategy. Preventive Medicine 1997;26:801-7. - PubMed
Cecchini 1989 {published data only}
    1. Cecchini S, Grazzini G, Bartoli D, Falvo I, Ciatto S. An attempt to increase compliance to cervical cancer screening through general practitioners. Tumori 1989;75(6):615-8. - PubMed
Chigbu 2017 {published data only}
    1. Chigbu CO, Onyebuchi AK, Onyeka TC, Odugu BU, Dim CC. The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria. International Journal of Gynecology & Obstetrics 2017;137(3):319-24. - PubMed
Chumworathayi 2007 {published data only}
    1. Chumworathayi B, Yuenyao P, Luanratanakorn S, Pattamadilok J, Chalapati W, Na-Nhongkai C. Can an appointment-letter intervention increase pap smear screening in Samliem, Khon Kaen, Thailand? Asian Pacific Journal of Cancer Prevention 2007;8(3):353-6. - PubMed
Cofta‐Woerpel 2009 {published data only}
    1. Cofta-Woerpel L, Randhawa V, McFadden HG, Fought A, Bullard E, Spring B. ACCISS study rationale and design: activating collaborative cancer information service information service support for cervical cancer screening. BMC Public Health 2009;9:444. - PMC - PubMed
Corkrey 2005 {published data only}
    1. Corkrey R, Parkinson L, Bates L. Pressing the key pad: trial of a novel approach to health promotion advice. Preventive Medicine 2005;41(2):657-66. - PubMed
Darlin 2013 {published data only}
    1. Darlin L, Borgfeldt C, Forslund O, Henic E, Hortlund M, Dillner J, et al. Comparison of use of vaginal HPV self-sampling and offering flexible appointments as strategies to reach long-term non-attending women in organized cervical screening. Journal of Clinical Virology 2013;58(1):155-60. - PubMed
Del Mar 1995 {published data only}
    1. Del Mar CB, Wright RG. Notifying women of the results of their cervical smear tests by mail: does it result in a decreased loss to follow-up of abnormal smears. Australian Journal of Public Health 1995;19(2):211-3. - PubMed
Del Mistro 2017 {published data only}
    1. De Mistro A, Frayle H, Ferro A, Fantin G, Altobelli E, Giorgi Rossi P. Efficacy of self-sampling in promoting participation to cervical cancer screening also in subsequent round. Preventive Medicine Reports 2016;23(5):166-8. - PMC - PubMed
Dignan 1996 {published data only (unpublished sought but not used)}
    1. Dignan M, Michielutte R, Blinson K, Wells HB, Case LD, Sharp P, et al. Effectiveness of health education to increase screening for cervical cancer among eastern-band Cherokee Indian women in North Carolina. Journal of the National Cancer Institute 1996;88(22):1670-6. - PubMed
Dignan 1998 {published data only (unpublished sought but not used)}
    1. Dignan MB, Michielutte R, Wells BH, Sharp P, Blinson K, Case LD, et al. Health education to increase screening for cervical cancer among Lumbee Indian women in North Carolina. Health Education Research 1998;13(4):545-56. - PubMed
Duggan 2012 {published data only}
    1. Duggan C, Coronado G, Martinez J, Byrd TL, Carosso E, Lopez C, et al. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women. BMC Cancer 2012;6:170. - PMC - PubMed
Duke 2015 {published data only}
    1. Duke P, Godwin M, Ratnam S, Dawson L, Fontaine D, Lear A, et al. Effect of vaginal self-sampling on cervical cancer screening rates: a community-based study in Newfoundland. BMC Women's Health 2015;10(15):47. - PMC - PubMed
Elder 2016 {published data only}
    1. Elder JP, Haughton J, Perez LG, Martinez ME, De La Torre CL, Slymen DJ, et al. Promotion of cancer screening among churchgoing Latinas: fe en Accion/Faith in Action. Health Education Research 2017;32(2):163-73. - PMC - PubMed
Enerly 2016 {published data only}
    1. Enerly E, Bonde J, Schee K, Pedersen H, Lonnberg S, Nygard M. Self-sampling for human papillomavirus testing among non-attenders increases attendance to the Norwegian cervical cancer screening programme. PlOS One 2016;11(4):e0151978. - PMC - PubMed
Engelstad 2005 {published data only}
    1. Engelstad LP, Stewart S, Otero-Sabogal R, Leung MS, Davis PI, Pasick RJ. The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer. Preventive Medicine 2005;41(3-4):741-8. - PubMed
Erwin 2012 {published data only}
    1. Erwin D, Thelemaque L, Saad-Harfouche F, Jandorf L. Esperanza y Vida intervention to increase breast and cervical cancer screening by Latinas: what are the crucial factors in outreach that influence behaviour change. Psycho-Oncology 2012;21:22-3.
German 1995 {published and unpublished data}
    1. German PS, Burton LC, Shapiro S, Steinwachs DM, Tsuji I, Paglia MJ, et al. Extended coverage for preventive services for the elderly: response and results in a demonstration population. American Journal of Public Health 1995;85(3):379-86. - PMC - PubMed
Giorgi Rossi 2011 {published data only}
    1. Giorgi Rossi P, Marsili LM, Camilloni L, Lossa A, Lattanzi A, Sani C, et al. The effect of self-sampled HPV testing on participation to cervical cancer screening in Italy: a randmised controlled trial (ISRCTN96071600). British Journal of Cancer 2011;104:248-54. - PMC - PubMed
Giorgi Rossi 2015 {published data only}
    1. Giorgi Rossi P, Fortunato C, Barbarino P, Boveri S, Caroli S, Del Mistro A, et al. Self-sampling to increase participation in cervical cancer screening: an RCT comparing home mailing, distribution in pharmacies, and recall letter. British Journal of Cancer 2015;112:667-75. - PMC - PubMed
Gok 2012 {published data only}
    1. Gok M, Van Kemenade FJ, Heideman DAM, Berkhof J, Rozendaal L, Spruyt JWM, et al. Experience with high-risk human papillomavirus testing on vaginal brush-based self-samples of non-attendees of the cervical screening program. International Journal of Cancer 2012;130:1128-35. - PubMed
Gotay 2000 {published data only}
    1. Gotay CC, Banner RO, Matsunaga DS, Hedlund N, Enos R, Issell BF, et al. Impact of a culturally appropriate intervention on breast and cervical screening among native Hawaiian women. Preventive Medicine 2000;31(5):529-37. - PubMed
Hancock 2001 {published data only}
    1. Hancock L, Sanson Fisher R, Perkins J, Corkrey R, Burton R, Reid S. Effect of a community action intervention on cervical cancer screening rates in rural Australian towns: the CART project. Preventive Medicine 2001;32(2):109-17. - PubMed
Hiatt 2008 {published data only}
    1. Hiatt RA, Pasick RJ, Stewart S, Bloom J, Davis P, Gardiner P, et al. Cancer screening for underserved women: the Breast and Cervical Cancer Intervention study. Cancer Epidemiology, Biomarkers & Prevention 2008;17(8):1945-9. - PubMed
Hicks 1997 {published and unpublished data}
    1. Hicks C, Robinson K. Cervical screening: the impact of the gender of the smear-taker on service uptake. Health Services Management Research 1997;10 (3):187-9. - PubMed
Hillman 1998 {published data only}
    1. Hillman AL, Ripley K, Goldfarb N, Nuamah I, Weiner J, Lusk E. Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care. American Journal of Public Health 1998;88(11):1699-701. - PMC - PubMed
Hitzeman 2012 {published data only}
    1. Hitzeman N, Xavier EM. Interventions to increase cervical cancer screening rates. American Family Physician 2012;85(5):443-5. - PubMed
Holloway 2003 {published data only}
    1. Holloway RM, Wilkinson C, Peters TJ, Russell I, Cohen D, Hale J, et al. Cluster-randomised trial of risk communication to enhance informed uptake of cervical screening. British Journal of General Practice 2003;53(493):620-5. - PMC - PubMed
Hou 2002 {published data only}
    1. Hou SI, Fernandez ME, Baumler E, Parcel GS. Effectiveness of an intervention to increase Pap test screening among Chinese women in Taiwan. Journal of Community Health 2002;27(4):277-90. - PubMed
Hou 2005 {published data only}
    1. Hou SI. Stage of adoption and impact of direct-mail communications with and without phone intervention on Chinese women's cervical smear screening behavior. Preventive Medicine 2005;41(3-4):749-56. - PubMed
Jenkins 1999 {published data only}
    1. Jenkins CN, McPhee SJ, Bird JA, Pham GQ, Nguyen BH, Nguyen T, et al. Effect of a media-led education campaign on breast and cervical cancer screening among Vietnamese-American women. Preventive Medicine 1999;28(4):395-406. - PubMed
Karwalajtys 2007 {published data only}
    1. Karwalajtys T, Kaczorowski J, Lohfeld L, Laryea S, Anderson K, Roder S, et al. Acceptability of reminder letters for Papanicolaou tests: a survey of women from 23 Family Health Networks in Ontario. Journal of Obstetrics & Gynaecology Canada 2007;29(10):829-34. - PubMed
Katz 2007 {published data only}
    1. Katz ML, Tatum CM, Degraffinreid CR, Dickinson S, Paskett ED. Do cervical cancer screening rates increase in association with an intervention designed to increase mammography usage? Journal of Women's Health 2007;16(1):24-35. - PMC - PubMed
Kobetz 2017 {published data only}
    1. Kobetz E, Seay J, Amofah A, Pierre L, Bispo JB, Trevil D, et al. Mailed HPV self-sampling for cervical cancer screening among underserved minority women: study protocol for a randomized controlled trial. Trials 2017;18(1):19. - PMC - PubMed
Krok‐Schoen 2016 {published data only}
    1. Krok-Schoen JL, Oliveri JM, Young GS, Katz ML, Tatum CM, Paskett ED. Evaluating the stage of change model to a cervical cancer screening intervention among Ohio Appalachian women. Womens Health 2016;56(4):468-86. - PMC - PubMed
Lairson 2010 {published data only}
    1. Lairson DR, Chang YC, Byrd TL, Smith JL, Wilson KM. Cost-effectiveness of promotora led health education interventions to increase cervical cancer screening among low income Hispanic women. Value in Health 2010:PCN74. [DOI: 10.1016/S1098-3015(10)72163-X] - DOI
Lam 2003 {published data only}
    1. Lam TK, McPhee SJ, Mock J, Wong C, Doan HT, Nguyen T, et al. Encouraging Vietnamese-American women to obtain Pap tests through lay health worker outreach and media education. Journal of General Internal Medicine 2003;18(7):516-24. - PMC - PubMed
Lantz 1995 {published and unpublished data}
    1. Lantz P, Stencil D, Lippert M, Beversdorf S, Jaros L, Remington P. Breast and cervical cancer screening in a low-income managed care sample: the efficacy of physician letters and phone calls.. American Journal of Public Health 1995;85(6):834-6. - PMC - PubMed
Lantz 1996 {published data only}
    1. Lantz PM, Stencil D, Lippert MT, Jaros L, Eaker ED. Implementation issues and costs associated with a proven strategy for increasing breast and cervical cancer screening among low-income women. Journal of Public Health Management and Practice 1996;2(3):54-9. - PubMed
Lauver 1990 {published data only}
    1. Lauver D, Rubin M. Message framing, dispositional optimism, and follow-up for abnormal Papanicolaou tests. Research in Nursing & Health 1990;13(3):199-207. - PubMed
Levine 2003 {published data only}
    1. Levine RS, Husaini BA, Emerson JS, Hull PC, Briggs NC, Moriarty CJ, et al. Using a nursing protocol to assure equitable delivery of cancer-related prevention services. Cellular & Molecular Biology 2003;49(8):1229-32. - PubMed
Litzelman 1993 {published data only}
    1. Litzelman DK, Dittus RS, Miller ME, Tierney WM. Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols. Journal of General Internal Medicine 1993;8(6):311-7. - PubMed
Lopez‐Torres Hidalgo 2016 {published data only}
    1. Lopez-Torres Hidalgo J, Sanchez Ortiz MP, Rabanales Sotos J, Simarro Herraez MJ, Lopez-Torres Lopez J, Campos Rosa M. Effectiveness of three interventions in improving adherence to cervical cancer screening. European Journal of Cancer Prevention 2016;25(5):423-9. - PubMed
Love 2009 {published data only}
    1. Love GD, Mouttapa M, Tanjasiri SP. Everybody's talking: using entertainment-education video to reduce barriers to discussion of cervical cancer screening among Thai women. Health Education Research 2009;24(5):829-38. - PMC - PubMed
Love 2012 {published data only}
    1. Love GD, Tanjasiri SP. Using entertainment-education to promote cervical cancer screening in Thai women. Journal of Cancer Education 2012;27(3):585-90. - PMC - PubMed
Luszczynska 2011 {published data only}
    1. Luszczynska A, Goc G, Scholz U, Kowalska M, Knoll N. Enhancing intentions to attend cervical cancer screening with a stage-matched intervention. British Journal of Health Psychology 2011;16(1):33-46. - PubMed
Lyimo 2012 {published data only}
    1. Lyimo FS, Beran TN. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: three public policy implications. BMC Public Health 2012;12:22. - PMC - PubMed
Lynch 2004 {published data only}
    1. Lynch FL, Whitlock EP, Valanis BG, Smith SK. Cost-effectiveness of a tailored intervention to increase screening in HMO women overdue for Pap test and mammography services. Preventive Medicine 2004;38(4):403-11. - PubMed
Maddocks 2011 {published data only}
    1. Maddocks H, Stewart M, Thind A, Terry AL, Chevendra V, Marshall JN, et al. Feedback and training tool to improve provision of preventive care by physicians using EMRs: a randomised control trial. Informatics in Primary Care 2011;19(3):147-53. - PubMed
Manfredi 1998 {published data only}
    1. Manfredi C, Czaja R, Freels S, Trubitt M, Warnecke R, Lacey L. Prescribe for health. Improving cancer screening in physician practices serving low-income and minority populations. Archives of Family Medicine 1998;7(4):329-37. - PubMed
Marcus 1992 {published data only (unpublished sought but not used)}
    1. Marcus AC, Crane LA, Kaplan CP, Reading AE, Savage E, Gunning J, et al. Improving adherence to screening follow-up among women with abnormal Pap smears: results from a large clinic-based trial of three intervention strategies. Medical Care 1992;30(3):216-30. - PubMed
Marcus 1998 {published data only}
    1. Marcus AC, Kaplan CP, Crane LA, Berek JS, Bernstein G, Gunning JE, et al. Reducing loss-to-follow-up among women with abnormal Pap smears. Results from a randomized trial testing an intensive follow-up protocol and economic incentives. Medical Care 1998;36(3):397-410. - PubMed
Margolis 1998 {published data only (unpublished sought but not used)}
    1. Margolis KL, Lurie N, McGovern PG, Tyrrell M, Slater JS. Increasing breast and cervical cancer screening in low-income women. Journal of General Internal Medicine 1998;13(8):515-21. - PMC - PubMed
Maxwell 2003 {published data only}
    1. Maxwell AE, Bastani R, Vida P, Warda US. Results of a randomized trial to increase breast and cervical cancer screening among Filipino American women. Preventive Medicine 2003;37(2):102-9. - PubMed
Mayer 1992 {published data only}
    1. Mayer JA, Slymen DJ, Drew JA, Wright BL, Elder JP, Williams SJ. Breast and cervical cancer screening in older women: the San Diego Medicare Preventive Health Project. Preventive Medicine 1992;21(4):395-404. - PubMed
Mbah 2015 {published data only}
    1. Mbah O, Ford JG, Qiu M, Wenzel J, Bone L, Bowie J, et al. Mobilizing social support networks to improve cancer screening: the COACH randomized controlled trial study design. BMC Cancer 2015;15:907. - PMC - PubMed
Miller 1999 {published data only}
    1. Miller SM, Buzaglo JS, Simms SL, Green V, Bales C, Mangan CE, et al. Monitoring styles in women at risk for cervical cancer: implications for the framing of health-relevant messages. Annals of Behavioral Medicine 1999;21(1):27-34. - PubMed
Miller 2007 {published data only}
    1. Miller E, Lasser KE, Becker AE. Breast and cervical cancer screening for women with mental illness: patient and provider perspectives on improving linkages between primary care and mental health. Archives of Women's Mental Health 2007;10(5):189-97. - PubMed
Miller 2017 {published data only}
    1. Miller KM, Ha DF, Chan RK, Andersen SW, Howell LP. Impact of a student-led community education program to promote Pap test screening among Asian-American women. Journal of American Society of Cytopathology 2017;6(4):145-54. - PubMed
Mitchell 1991 {published data only}
    1. Mitchell H, Hirst S, Cockburn J, Reading DJ, Staples MP, Medley G. Cervical cancer screening: a comparison of recruitment strategies among older women. Medical Journal of Australia 1991;155(2):79-82. - PubMed
Mitchell 1997 {published data only}
    1. Mitchell H, Hirst S, Mitchell JA, Staples M, Torcello N. Effect of ethnic media on cervical cancer screening rates. Australian and New Zealand Journal of Public Health 1997;21(3):265-7. - PubMed
Murphy 2015 {published data only}
    1. Murphy ST. Telling stories, saving lives: creating narrative health messages to reduce cancer disparities. Cancer Epidemiology, Biomarkers and Prevention (7th AACR Conference on the Science of Health Disparities in Racial/Ethnic Minorities and Medically Underserved) 2015;24(10 Suppl):IA04.
Mutyaba 2009 {published data only}
    1. Mutyaba T, Mirembe F, Sandin S, Weiderpass E. Male partner involvement in reducing loss to follow-up after cervical cancer screening in Uganda. International Journal of Gynaecology and Obstetrics 2009;107(2):103-6. - PubMed
Newell 2002 {published data only}
    1. Newell SA, Sanson Fisher RW, Girgis A, Davey HM. Can personal health record booklets improve cancer screening behaviors? American Journal of Preventive Medicine 2002;22(1):15-22. - PubMed
Nguyen 2000 {published data only}
    1. Nguyen BH, Nguyen KP, McPhee SJ, Nguyen AT, Tran DQ, Jenkins CN. Promoting cancer prevention activities among Vietnamese physicians in California. Journal of Cancer Education 2000;15(2):82-5. - PubMed
Okeke 2013 {published data only}
    1. Okeke EN, Adepiti CA, Ajenifuja KO. What is the price of prevention: new evidence from a field experiment. Journal of Health Economics 2013;32(1):207-18. - PubMed
Park 2005 {published data only}
    1. Park S, Chang S, Chung C. Effects of a cognition-emotion focused program to increase public participation in Papanicolaou smear screening. Public Health Nursing 2005;22(4):289-98. - PubMed
Paskett 1990 {published and unpublished data}
    1. Paskett ED, White E, Carter WB, Chu J. Improving follow-up after an abnormal Pap smear: a randomized controlled trial. Preventive Medicine 1990;19(6):630-41. - PubMed
Paskett 1995 {published data only}
    1. Paskett ED, Phillips KC, Miller ME. Improving compliance among women with abnormal Papanicolaou smears. Obstetrics and Gynecology 1995;86(3):353-9. - PubMed
Paskett 1999 {published data only}
    1. Paskett ED, Tatum CM, D'Agostino R Jr, Rushing J, Velez R, Michielutte R, et al. Community-based interventions to improve breast and cervical cancer screening: results of the Forsyth County Cancer Screening (FoCaS) Project. Cancer Epidemiology, Biomarkers & Prevention 1999;8(5):453. - PubMed
Paul 2003 {published data only}
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Perkins 2007 {published data only}
    1. Perkins RB, Langrish S, Stern LJ, Simon CJ. A community-based education program about cervical cancer improves knowledge and screening behavior in Honduran women. Pan American Journal of Public Health 2007;22(3):187-93. - PubMed
Peters 1999 {published data only (unpublished sought but not used)}
    1. Peters T, Somerset M, Baxter K, Wilkinson C. Anxiety among women with mild dyskaryosis: a randomized trial of an educational intervention. British Journal of General Practice 1999;49:348-52. - PMC - PubMed
Philips 2006 {published data only}
    1. Philips Z, Whynes DK, Avis M. Testing the construct validity of willingness to pay valuations using objective information about risk and health benefit. Health Economics 2006;15(2):195-204. - PubMed
Piana 2011 {published data only}
    1. Piana L, Leandri FX, Le Retraite L, Heid P, Tamalet C, Sancho-Garnier H. HPV-Hr detection by home self sampling in women not compliant with Pap test for cervical cancer screening. Results of a pilot programme in Bouches-du-Rhone. Bulletin du Cancer 2011;98(7):723-31. - PubMed
Pirzadeh 2012 {published data only}
    1. Pirzadeh A, Mazaheri MA. The effect of education on women's practice based on the health belief model about Pap smear test. International Journal of Preventive Medicine 2012;3(8):585-90. - PMC - PubMed
Powers 1992 {published data only}
    1. Powers RL, Shumway JM. Written patient reminders improve cancer screening practices. Clinical Research 1992;40(2):A610.
Rock 2014 {published data only}
    1. Rock JA, Acuna JM, Lozano JM, Martinez IL, Greer PJ Jr, Brown DR, et al. Impact of an academic-community partnership in medical education on community health: evaluation of a novel student-based home visitation program. Southern Medical Journal 2014;107(4):203-11. - PubMed
Roetzheim 2004 {published data only}
    1. Roetzheim RG, Christman LK, Jacobsen PB, Cantor AB, Schroeder J, Abdulla R, et al. A randomized controlled trial to increase cancer screening among attendees of community health centers. Annals of Family Medicine 2004;2(4):294-300. - PMC - PubMed
Roetzheim 2005 {published data only}
    1. Roetzheim RG, Christman LK, Jacobsen PB, Schroeder J, Abdulla R, Hunter S. Long-term results from a randomized controlled trial to increase cancer screening among attendees of community health centers. Annals of Family Medicine 2005;3(2):109-14. - PMC - PubMed
Ruffin 2004 {published data only}
    1. Ruffin IVMT, Gorenflo DW, Murff HJ. Increasing cancer screening rates in primary care: no easy solutions. Journal of Clinical Outcomes Management 2004;11(12):754-5.
Sancho‐Garnier 2013 {published data only}
    1. Sancho-Garnier H, Tamalet C, Halfon P, Leandri FX, Le Retraite L, Djoufelkit K, et al. HPV self-sampling or the Pap-smear: a randomized study among cervical screening nonattenders from lower socioeconomic groups in France. International Journal of Cancer 2013;133:2681–7. - PubMed
Sankaranarayanan 2003 {published data only}
    1. Sankaranarayanan R, Rajkumar R, Arrossi S, Theresa R, Esmy PO, Mahe C, et al. Determinants of participation of women in a cervical cancer visual screening trial in rural south India. Cancer Detection & Prevention 2003;27(6):457-65. - PubMed
Scoggins 2010 {published data only}
    1. Scoggins JF, Ramsey SD, Jackson JC, Taylor VM. Cost effectiveness of a program to promote screening for cervical cancer in the Vietnamese-American population. Asian Pacific Journal of Cancer Prevention 2010;11(3):717-22. - PMC - PubMed
Sewali 2015 {published data only}
    1. Sewali B, Okuyemi KS, Askhir A, Belinson J, Vogel RI, Joseph A, et al. Cervical cancer screening with clinic-based Pap test versus home HPV test among Somali immigrant women in Minnesota: a pilot randomized controlled trial. Cancer Medicine 2015;4:620-31. - PMC - PubMed
Shastri 2014 {published data only}
    1. Shastri SS, Mittra I, Mishra GA, Gupta S, Dikshit R, Singh S, et al. Effect of VIA screening by primary health workers: randomized controlled study in Mumbai, India. Journal of the National Cancer Institute 2014;106(3):dju009. - PMC - PubMed
Shelley 1991 {published data only}
    1. Shelley JM, Irwig LM, Simpson JM, Macaskill P. Evaluation of a mass-media-led campaign to increase Pap smear screening. Health Education Research 1991;6(3):267-77. - PubMed
Shenson 2011 {published data only}
    1. Shenson D, Adams M, Bolen J, Anderson L. Routine checkups don't ensure that seniors get preventive services. Journal of Family Practice 2011;60(1):E1-10. - PubMed
Shojaeizadeh 2011 {published data only}
    1. Shojaeizadeh D, Hashemi SZ, Moeini B, Poorolajal J. The effect of educational program on increasing cervical cancer screening behaviour among women in Hamadan, Iran: Applying Health Belief Model. Journal of Research in Health Sciences 2011;11(1):20-5. - PubMed
Smith 2013 {published data only}
    1. Smith JL, Wilson KM, Orians CE, Byrd TL. AMIGAS: building a cervical cancer screening intervention for public health practice. Journal of Womens Health 2013;22(9):718-23. - PMC - PubMed
Stewart 1994 {published data only}
    1. Stewart DE, Buchegger PM, Lickrish GM, Sierra S. The effect of educational brochures on follow-up compliance in women with abnormal Papanicolaou smears. Obstetrics and Gynecology 1994;83(4):583-5. - PubMed
Sultana 2014 {published data only}
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Sultana 2016 {published data only}
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References to studies awaiting assessment

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References to other published versions of this review

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Publication types