Dataset Information

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.

SUBMITTER: Gates A

PROVIDER: S-EPMC7777363 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Screening for the prevention and early detection of cervical cancer: protocol for systematic reviews to inform Canadian recommendations.

Gates Allison A Pillay Jennifer J Reynolds Donna D Stirling Rob R Traversy Gregory G Korownyk Christina C Moore Ainsley A Thériault Guylène G Thombs Brett D BD Little Julian J Popadiuk Catherine C van Niekerk Dirk D Keto-Lambert Diana D Vandermeer Ben B Hartling Lisa L

Systematic reviews 20210102 1

<h4>Purpose</h4>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.<h4>Methods</h4>De novo reviews will be conducted to evaluate effectiveness and to assess values and preferences. For test accuracy and strategie ...[more]

PMID: 33388083

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Project description:Background:Zika virus (ZIKV) has recently emerged as a disease of significant public health concern. Currently, a large outbreak is occurring predominantly located in the Americas. ZIKV infection is a cause of microcephaly and other congenital abnormalities and can cause post-infectious neurologic complications such as Guillain-Barré syndrome. Objective:To review current knowledge of ZIKV infection and to provide guidance to health care professionals who provide advice to Canadians who may be impacted by ZIKV infection. Methods:This Statement was developed by a working group of the Committee to Advise on Tropical Medicine and Travel (CATMAT). Recommendations are based on a literature review and clinical judgment. Results:All travellers should use personal protective measures against mosquito bites including insect repellents and protection of living areas against mosquito entry. Pregnant women should avoid travel to areas designated by the Public Health Agency of Canada as being of concern because of ongoing ZIKV transmission. Women planning a pregnancy should consult with their health care provider and consider postponing travel to these areas. All other travellers may wish to consider deferring travel to designated areas based on risk tolerance, values, and preferences.?: Sexual transmission of ZIKV from male partners has been documented and couples should practise abstinence or use condoms for the duration of a pregnancy, while in a risk area, or until viral shedding has likely ceased. In the absence of clear data, we make the assumption that viral shedding is unlikely to persist beyond 6 months for men and two months for non-pregnant women.?: Health care providers should take a travel history from their pregnant patients including relevant information related to the travel history of their partner(s). Screening and management recommendations are provided for all travellers including potentially contagious male partners, pregnant women (symptomatic and asymptomatic), and the fetus or infant of potentially infected women. There is no specific antiviral therapy for the treatment of ZIKV infection. Conclusion:Robust quantitative assessments for the full spectrum of ZIKV-associated risks are not possible. This reflects, among other things, uncertainties related to the likelihood of infection among travellers to ZIKV-affected areas, vertical transmission from mother to fetus, sexual transmission (from symptomatic or asymptomatic partners), and serious ZIKV-associated sequelae among travellers. Given this uncertainty, as well as the potentially severe effects of ZIKV infection on the fetus, recommendations are conservative. CATMAT will update its recommendations as new information becomes available.

Dataset Information

Screening for the prevention and early detection of cervical cancer: protocol for systematic reviews to inform Canadian recommendations.

Purpose

Methods

Discussion

Publications

Screening for the prevention and early detection of cervical cancer: protocol for systematic reviews to inform Canadian recommendations.

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