The CPCRN Cervical Cancer Workgroup recently published an article, “Reducing Overuse of Cervical Cancer Screening: A Systematic Review,” in the American Journal of Preventive Medicine.
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.
Citation: Alber, J. M., Brewer, N. T., Melvin, C., Yackle, A., Smith, J. S., Ko, L. K., Crawford, A., & Glanz, K. Reducing overuse of cervical cancer screening: A systematic review. American Journal of Preventive Medicine, 116, 51-59. https://doi.org/10.1016/j.ypmed.2018.08.027
Acknowledgements: Amber Cohen, Jade Avelis, Meagan Robichaud, Matt Kearney, Ryan Quinn, Jenny Spencer, Dana Burshell.