Screening for the Prevention and Early Detection of Cervical Cancer: Protocol for Systematic Reviews to Inform Canadian Recommendations

Abstract

Purpose. To inform recommendations by the Canadian Task Force on Preventive Health Care on screening in primary care for the prevention and early detection of cervical cancer by systematically reviewing evidence of: (a) effectiveness; (b) test accuracy; (c) individuals’ values and preferences, and (d) strategies aimed at improving screening rates.Methods. De novo reviews will be conducted to evaluate effectiveness and to assess values and preferences. For test accuracy and strategies to improve screening rates, we will integrate studies from existing systematic reviews with search updates to the present. Two Cochrane reviews will provide evidence of adverse pregnancy outcomes from the conservative management of cervical intraepithelial neoplasia. We will search Medline, Embase, and Cochrane Central (except for individuals’ values and preferences, where Medline, Scopus, and EconLit will be searched) via peer-reviewed search strategies, and the reference lists of included studies and reviews. We will search ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. Two reviewers will screen potentially eligible studies and agree on those to include. Data will be extracted by one reviewer with verification by another. Two reviewers will independently assess risk of bias and reach consensus. Where possible and suitable, we will pool studies via meta-analysis. We will compare accuracy data per outcome and per comparison using the Rutter and Gatsonis hierarchical summary receiver operating characteristic model and report relative sensitivities and specificities. Findings on values and preferences will be synthesized using a narrative synthesis approach and thematic analysis, depending on study designs. Two reviewers will appraise the certainty of evidence for all outcomes using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and come to consensus.Discussion. The publication of guidance on screening in primary care for the prevention and early detection of cervical cancer by the Task Force in 2013 focused on cytology. Since 2013, new studies using human papillomavirus tests for cervical screening have been published that will improve our understanding of screening in primary care settings. This review will inform updated recommendations based on currently available studies and address key evidence gaps noted in our previous review.Systematic review registration: not registered.

Identification of a Ferroptosis-Related Prognostic Gene PTGS2 Based on Risk Modeling and Immune Microenvironment of Early-Stage Cervical Cancer

“…As reported, CC always develops with strong concealment and high mortality. Though researches on the prediction and detection against early cervical cancer had been covered by studies [24][25][26], few of them were established on the genetic molecular level or concentrated on specific FRGs affecting prognosis in the field of CC. We cut in the theme in the light of the expression information of early CC patients and a prognostic model designed via Cox-LASSO combined methods and based on the gene-expression was constructed.…”

HPV Vaccine: Integrative Review of National and International Guidelines

“…This format has been used in several other countries and demonstrates good results. However, the access factor to vaccination sites is an important logistical and social barrier, especially in underdeveloped or developing countries [22].…”