Cervical Cancer Screening, Diagnosis and Treatment Interventions for Racial and Ethnic Minorities: A Systematic Review

Abstract

OBJECTIVES To systematically review the literature to determine which interventions improve the screening, diagnosis or treatment of cervical cancer for racial and/or ethnic minorities. DATA SOURCES Medline on OVID, Cochrane Register of Controlled Trials, CINAHL, PsycINFO and Cochrane Systematic Reviews. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS We searched the above databases for original articles published in English with at least one intervention designed to improve cervical cancer prevention, screening, diagnosis or treatment that linked participants to the healthcare system; that focused on US racial and/or ethnic minority populations; and that measured health outcomes. Articles were reviewed to determine the population, intervention(s), and outcomes. Articles published through August 2010 were included. STUDY APPRAISAL AND SYNTHESIS METHODS One author rated the methodological quality of each of the included articles. The strength of evidence was assessed using the criteria developed by the GRADE Working Group.45,46 RESULTS Thirty-one studies were included. The strength of evidence is moderate that telephone support with navigation increases the rate of screening for cervical cancer in Spanish- and English-speaking populations; low that education delivered by lay health educators with navigation increases the rate of screening for cervical cancer for Latinas, Chinese Americans and Vietnamese Americans; low that a single visit for screening for cervical cancer and follow up of an abnormal result improves the diagnosis and treatment of premalignant disease of the cervix for Latinas; and low that telephone counseling increases the diagnosis and treatment of premalignant lesions of the cervix for African Americans. LIMITATIONS Studies that did not focus on racial and/or ethnic minority populations may have been excluded. In addition, this review excluded interventions that did not link racial and ethnic minorities to the health care system. While inclusion of these studies may have altered our findings, they were outside the scope of our review. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Patient navigation with telephone support or education may be effective at improving screening, diagnosis, and treatment among racial and ethnic minorities. Research is needed to determine the applicability of the findings beyond the populations studied.

A Roadmap and Best Practices for Organizations to Reduce Racial and Ethnic Disparities in Health Care

“…[2][3][4][5][6] While many valuable ideas to address racial and ethnic health disparities are being pursued outside of the healthcare system, Finding Answers focuses specifically on what can be accomplished once regular access to healthcare services is achieved. Thus, the reviews focused on interventions that occur in or have a sustained linkage to a healthcare delivery setting; programs that were strictly communitybased were outside the scope of the project.…”

“…Based on low to moderate evidence, the cervical cancer review reported that navigation combined with either education delivered by lay health educators or telephone support can increase the rate of screening for cervical cancer among minority populations. 2 Telephone counseling might also increase the diagnosis and treatment of premalignant lesions of the cervix for minority women. The prostate cancer review focused on the importance of informed decision making for addressing prostate cancer among racial and ethnic minority men.…”

“…Over the past seven years, Finding Answers has funded 33 research projects and performed 12 systematic literature reviews, including the five papers in this symposium. [2][3][4][5][6] We are now beginning to leverage this research base to provide technical assistance to organizations that are implementing disparities reduction interventions, such as those participating in RWJF's Aligning Forces for Quality program. 7 This paper summarizes the major lessons learned from the systematic reviews and provides a disparities reduction framework.…”

MicroRNA-106a promotes cell migration and invasion by targeting tissue inhibitor of matrix metalloproteinase 2 in cervical cancer

“…Despite notable advances in surgery, radiotherapy and chemotherapy, even the novel molecular-targeted therapy, the long-term survival of advanced CC patients remains poor due to the high rates of tumor recurrence and distal metastasis (3)(4)(5). To elucidate the development and progression of CC, it is crucial to identify the molecular etiology and molecular mechanisms underlying the progression and metastasis in CC and thus improve therapeutic strategies and prognosis.…”

Health Disparities between Black Hispanic and Black Non-Hispanic Cervical Cancer Cases in the USA

“…There has been a consistent failure in reaching the most disadvantaged and at risk populations (Glick et al, 2012;Saslow et al, 2012;Simard et al, 2012). An increase in cervical cancer screening between the years 1993 and 2007 has resulted in a decline in cervical cancer related mortality.…”