Reducing overuse of cervical cancer screening: A systematic review

被引:20
作者
Alber, Julia M. [1 ,6 ]
Brewer, Noel T. [2 ]
Melvin, Cathy [3 ]
Yackle, Alyssa [1 ,7 ]
Smith, Jennifer S. [2 ]
Ko, Linda K. [4 ]
Crawford, Anatasha [5 ,8 ]
Glanz, Karen [1 ]
机构
[1] Univ Penn, Philadelphia, PA 19104 USA
[2] Univ N Carolina, Chapel Hill, NC 27599 USA
[3] Med Univ South Carolina, Charleston, SC 29425 USA
[4] Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N M3-8232, Seattle, WA 98109 USA
[5] Oak Ridge Inst Sci Educ, 100 ORAU Way, Oak Ridge, TN 37830 USA
[6] Calif Polytech State Univ San Luis Obispo, Dept Kinesiol & Publ Hlth, San Luis Obispo, CA 93407 USA
[7] Soc Clin Res Associates, 530 W Butler Dr 109, Chalfont, PA 18914 USA
[8] TRM Oncol, 5901 Peachtree Dunwoody Rd NE, Atlanta, GA 30328 USA
关键词
Quality of care; Cancer screening; Appropriate use; Overuse; Pap tests; RECORD-BASED TOOLS; LOW-VALUE CARE; PREVENTIVE-SERVICES; AMERICAN-COLLEGE; OLDER WOMEN; GUIDELINES; HEALTH; GYNECOLOGISTS; PATIENT; RECOMMENDATIONS;
D O I
10.1016/j.ypmed.2018.08.027
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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.
引用
收藏
页码:51 / 59
页数:9
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