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Cancer Screening: Group Education for Clients – Cervical Cancer


What the CPSTF Found

About The Systematic Review

The Task Force 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 Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to cancer prevention and control. This finding updates and replaces the 2008 Task Force finding on Cancer Screening: Group Education – Cervical Cancer [PDF - 260 kB].


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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

The updated search for evidence included studies about breast, cervical, or colorectal cancer screening. Only one study about breast cancer qualified for the review. Monetary values are presented in 2009 U.S dollars.

  • The cost to implement the intervention for one year was estimated at $12.87 per woman educated, assuming 250 presentations were conducted with approximately 2,500 participants.
  • Volunteers provided breast screening education. The majority of the program cost (80%) was for the salary of the volunteer coordinator.


Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.

Evidence Gaps

Each Community Preventive Services Task Force (Task Force) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the Task Force finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the Task Force recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the Task Force recommendation is based.

Identified Evidence Gaps

The following outlines evidence gaps for group education 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?

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.