Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
10143818 | Preventive Medicine | 2018 | 9 Pages |
Abstract
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 (nâ¯=â¯7), OBGYN practice or provider (nâ¯=â¯5), location (nâ¯=â¯4), and marital status (nâ¯=â¯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.
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Authors
Julia M. Alber, Noel T. Brewer, Cathy Melvin, Alyssa Yackle, Jennifer S. Smith, Linda K. Ko, Anatasha Crawford, Karen Glanz,