Cancer Screening: Group Education for Clients — Cervical Cancer

Related Pages

Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) recommends the use of client reminders to increase screening for cervical cancers on the basis of strong evidence of effectiveness.

The full CPSTF Finding and Rationale Statement and supporting documents for Increasing Cancer Screening: Group Education for Clients [for Breast, Cervical, and Colorectal Cancers] are available in The Community Guide Collection on CDC Stacks.

Intervention

Group education conveys information on indications for, benefits of, and ways to overcome barriers to screening with the goal of informing, encouraging, and motivating participants to seek recommended screening. Group education is usually conducted by health professionals or by trained lay people who use presentations or other teaching aids in a lecture or interactive format, and often incorporate role modeling or other methods. Group education can be given to a variety of groups, in different settings, and by different types of educators with different backgrounds and styles.

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 (3 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.

Study Characteristics

  • Education sessions were delivered by lay health workers or peer facilitators (3 studies) or health professionals (2 studies).
  • Where specified, interventions were conducted in the U.S., among African Americans, Latin Americans, Filipino Americans, and whites, and in populations of low- to mixed- or middle-class socioeconomic status.
  • Most programs were delivered in churches or homes in the community.

Summary of Results

Five studies qualified for the updated systematic review.

  • Pap tests: median increase of 10.6 percentage points (range 0 to 59.1; 4 studies)
  • One study reported mixed results for cervical cancer screening, depending on whether the results were reported at the group or individual level.
  • 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 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 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 client incentives to increase breast, cervical, or colorectal cancer screening.

  • Are group education interventions that target specific groups more effective in increasing breast, cervical, or colorectal cancer screening within those groups than within untargeted interventions?
  • Does effectiveness vary with intensity of education sessions or specific components included in them?
  • 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?

Implementation Considerations and Resources

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.

Crosswalks

Find programs from the Evidence-Based Cancer Control Programs EBCCP website that align with this systematic review. (What is EBCCP?)