Reducing overuse of cervical cancer screening: A systematic review
A partir d'une revue systématique de la littérature publiée entre 1990 et 2016 (25 articles), cette étude identifie les facteurs associés à l'utilisation excessive d'examens de dépistage du cancer du col utérin ainsi que les stratégies permettant de réduire cette utilisation excessive
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.
Preventive Medicine , résumé, 2018