Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial

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RECERCAT Home > Universitat Internacional de Catalunya > Recerca > Articles > Ciències de la Salut > View document

To access the full text documents, please follow this link: http://hdl.handle.net/20.500.12328/1383

dc.contributor.author	Acera Pérez, Amelia
dc.contributor.author	Manresa, Josep Maria
dc.contributor.author	Rodriguez, Diego
dc.contributor.author	Rodriguez, Ana
dc.contributor.author	Bonet Simó, Josep Maria
dc.contributor.author	Trapero Bertran, Marta
dc.contributor.author	Hidalgo Valls, Pablo
dc.contributor.author	Sànchez, Norman
dc.contributor.author	De Sanjosé, Silvia
dc.date	2019-12-08T16:19:19Z
dc.date	2019-12-08T16:19:19Z
dc.date	2017-01-24
dc.identifier	Acera, Amelia; Manresa, Josep Maria; Rodriguez, Diego [et al.]. Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial. PLoS ONE, 2017, vol. 12, núm. 1, e0170371. Disponible en: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170371>. Fecha de acceso: 8 dic. 2019. DOI: 10.1371/journal.pone.0170371.
dc.identifier	1932-6203
dc.identifier	https://dx.doi.org/10.1371/journal.pone.0170371
dc.identifier.uri	http://hdl.handle.net/20.500.12328/1383
dc.description	Background: Opportunistic cervical cancer screening can lead to suboptimal screening coverage. Coverage could be increased after a personalised invitation to the target population. We present a community randomized intervention study with three strategies aiming to increase screening coverage. Methods: The CRICERVA study is a community-based clinical trial to improve coverage of population-based screening in the Cerdanyola SAP area in Barcelona.A total of 32,858 women residing in the study area, aged 30 to 70 years were evaluated. A total of 15,965 women were identified as having no registration of a cervical cytology in the last 3.5 years within the Public Health data base system. Eligible women were assigned to one of four community randomized intervention groups (IGs): (1) (IG1 N = 4197) personalised invitation letter, (2) (IG2 N = 3601) personalised invitation letter + informative leaflet, (3) (IG3 N = 6088) personalised invitation letter + informative leaflet + personalised phone call and (4) (Control N = 2079) based on spontaneous demand of cervical cancer screening as officially recommended. To evaluate screening coverage, we used heterogeneity tests to compare impact of the interventions and mixed logistic regression models to assess the age effect. We refer a “rescue” visit as the screening visit resulting from the study invitation. Results: Among the 13,886 women in the IGs, 2,862 were evaluated as having an adequate screening history after the initial contact; 4,263 were lost to follow-up and 5,341 were identified as having insufficient screening and thus being eligible for a rescue visit. All intervention strategies significantly increased participation to screening compared to the control group. Coverage after the intervention reached 84.1% while the control group reached 64.8%. The final impact of our study was an increase of 20% in the three IGs and of 9% in the control group (p<0.001). Within the intervention arms, age was an important determinant of rescue visits showing a statistical interaction with the coverage attained in the IGs. Within the intervention groups, final screening coverage was significantly higher in IG3 (84.4%) (p<0.001). However, the differences were more substantial in the age groups 50–59 and those 60+. The highest impact of the IG3 intervention was observed among women 60+ y.o with 32.0% of them being rescued for screening. The lowest impact of the interventions was in younger women. Conclusions: The study confirms that using individual contact methods and assigning a fixed screening date notably increases participation in screening. The response to the invitation is strongly dependent on age.
dc.format	11
dc.format	application/pdf
dc.language	eng
dc.publisher	Public Library of Science
dc.relation	PLoS One
dc.relation	12;1
dc.relation	info:eu-repo/grantAgreement/ES/1PE/PI10/01275
dc.relation	info:eu-repo/grantAgreement/ES/PI10/01275
dc.relation	info:eu-repo/grantAgreement/ES/2014SGR2016
dc.rights	© 2017 Acera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights	https://creativecommons.org/licenses/by/4.0/
dc.subject	Càncer
dc.subject	Cribatge (Medicina)
dc.subject	Grups d'edat
dc.subject	Citologia
dc.subject	Mortalitat
dc.subject	Telèfon--Aparells i accessoris
dc.subject	Europa
dc.subject	Salut pública
dc.subject	Salut laboral
dc.subject	Cáncer
dc.subject	Cribado
dc.subject	Citología
dc.subject	Mortalidad
dc.subject	Teléfono
dc.subject	Salud pública
dc.subject	Salud laboral
dc.subject	Cervical cancer
dc.subject	Age groups
dc.subject	Cytology
dc.subject	Death rate
dc.subject	Telephones
dc.subject	Europe
dc.subject	Public health
dc.subject	Occupational Health
dc.subject	61
dc.title	Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/acceptedVersion

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