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Title:
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Analysis of three strategies to increase screening coverage for cervical cancer in the general population of women aged 60 to 70 years: the CRICERVA study
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Author:
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Acera Pérez, Amelia; Manresa, Josep Maria; Rodríguez, Diego A.; Rodriguez, Ana; Bonet Simó, Josep Maria; Sánchez, Norman; Hidalgo Valls, Pablo; Soteras, Pilar; Torán-Monserrat, Pere; Trapero Bertran, Marta; Lozano, Iris; De Sanjosé, Silvia
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Notes:
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Background: Cervical cancer is a frequently diagnosed cancer in women worldwide. Despite having easy
preventive and therapeutic approaches, it is an important cause of mortality among women.
Methods: The CRICERVA study is a cluster clinical trial which assigned one of three interventions to the target
population registered in Cerdanyola, Barcelona. Among the 5,707 resident women aged 60 to 70 years in the study
area, women with no record of cervical cytology over the last three years were selected. The study included four
arms: three interventions all including a pre-assigned date for screening visit and i) personalized invitation letter;
ii) adding to i) an informative leaflet; and, iii) in addition to ii) a personalized appointment reminder phone call, and
iv) no specific action taken (control group). Participants were offered a personal interview about social-demographic
characteristics and about screening attitudes. Cervical cytology and HPV DNA test (HC2) were offered as screening
tests. In the case of screening positive in any of these tests, the women were followed up until a full diagnosis
could be obtained. The effect size of each study arm was estimated as the absolute gain in coverage between the
original coverage and the final coverage.
Results: From the intervention groups (4,775 women), we identified 3,616 who were not appropriately screened, of
which 2,560 women answered the trial call and 1,376 were amenable to screening. HPV was tested in 920 women
and cervical cytology in all 1,376. Overall, there was an absolute gain in coverage of 28.8% in the intervention
groups compared to 6% in the control group. Coverage increased from 51.2% to 76.0% in strategy i); from 47.4% to
79.0% in strategy ii) and from 44.5% to 74.6% in strategy iii). Lack of information about the relevance of screening
was the most important factor for not attending the screening program.
Conclusions: The study confirms that actively contacting women and including a date for a screening visit, notably
increased participation in the screening program. Efforts to improve health education in preventative activities are
warranted. |
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Subject(s):
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-Ginecologia
-Gynecology
-Ginecología
-Assaigs clínics
-Clinical trials
-Ensayos clínicos
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-61 |
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Rights:
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http://creativecommons.org/licenses/by-nc-nd/4.0/
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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Document type:
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Article
Article - Accepted version |
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Published by:
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BMC
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Share:
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