1. Reducing overuse of cervical cancer screening: A systematic review
- Author
-
Anatasha Crawford, Karen Glanz, Alyssa Yackle, Julia M. Alber, Jennifer S. Smith, Linda K. Ko, Cathy L. Melvin, and Noel T. Brewer
- Subjects
medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,Psychological intervention ,Uterine Cervical Neoplasms ,Medical Overuse ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intervention (counseling) ,Preventive Health Services ,Health care ,Cancer screening ,medicine ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Early Detection of Cancer ,Hysterectomy ,business.industry ,Public Health, Environmental and Occupational Health ,030220 oncology & carcinogenesis ,Marital status ,Female ,Observational study ,business - Abstract
Overuse of clinical preventive services increases healthcare costs and may deprive underserved patients of necessary care. Up to 45% of cervical cancer screening is overuse. We conducted a systematic review of correlates of overuse of cervical cancer screening and interventions to reduce overuse. The search identified 25 studies (20 observational; 5 intervention). Correlates varied by the type of overuse measured (i.e., too frequent, before/after recommended age to start or stop screening, after hysterectomy), the most common correlates of overuse related to patient age (n = 7), OBGYN practice or provider (n = 5), location (n = 4), and marital status (n = 4). Six observational studies reported a decrease in overuse over time. Screening overuse decreased in all intervention studies, which used before-after designs with no control or comparison groups. Observational studies suggest potential targets for de-escalating overuse. Randomized clinical trials are needed to establish best practices for reducing overuse.
- Published
- 2018
- Full Text
- View/download PDF