OBJECTIVE: The first aim of this article is to quantify the role of Pap test in cervical cancer prevention, updating the pool of available studies included in a previous meta-analysis. Potential sources of meta-analysis heterogeneity were investigated as second aim. Further evidence of cost-effectiveness has been provided about age and best time interval to perform Pap test screening. DATA SOURCES: The articles' search was conducted using four medical electronic databases: PubMed, Google Scholar, ISI Web, and Scopus. Papers published until the 30th November 2013 were included. The research on Google Scholar was limited to the first 10 pages of web for each study design. METOD OF STUDY SELECTION: A systematic review/meta-analysis was performed according to PRISMA Statement. New-Castle-Ottawa Scale and Jadad have been adopted for articles quality assessment. From 4143 screened articles, 34 met eligibility criteria and 30 case-control studies were included in meta-analysis. Meta-analysis was carried out using StatsDirect2.8.0. Heterogeneity was investigated with qualitative and quantitative approaches in sensitivity-analysis. TABULATION, INTEGRATION AND RESULTS: Despite a great heterogeneity (Cochran Q=504.466, df=29, p<0.0001; I²=94.3%; 95%CI=93.1%-95.1%), a significant protective effect of Pap test has been identified (OR=0.33; 95%CI=0.268-0.408, P <0.00011) through the meta-analysis. Sensitivity analysis did not provide significant results (R=0.358 R2=0.128 p<0.469). CONCLUSIONS: The protective role of Pap test against cervical cancer has been confirmed especially among women <40 years. Annual screening still remains the most cost-effective preventive strategy.
OBJECTIVE: The first aim of this article is to quantify the role of Pap test in cervical cancer prevention, updating the pool of available studies included in a previous meta-analysis. Potential sources of meta-analysis heterogeneity were investigated as second aim. Further evidence of cost-effectiveness has been provided about age and best time interval to perform Pap test screening. DATA SOURCES: The articles' search was conducted using four medical electronic databases: PubMed, Google Scholar, ISI Web, and Scopus. Papers published until the 30th November 2013 were included. The research on Google Scholar was limited to the first 10 pages of web for each study design. METOD OF STUDY SELECTION: A systematic review/meta-analysis was performed according to PRISMA Statement. New-Castle-Ottawa Scale and Jadad have been adopted for articles quality assessment. From 4143 screened articles, 34 met eligibility criteria and 30 case-control studies were included in meta-analysis. Meta-analysis was carried out using StatsDirect2.8.0. Heterogeneity was investigated with qualitative and quantitative approaches in sensitivity-analysis. TABULATION, INTEGRATION AND RESULTS: Despite a great heterogeneity (Cochran Q=504.466, df=29, p<0.0001; I²=94.3%; 95%CI=93.1%-95.1%), a significant protective effect of Pap test has been identified (OR=0.33; 95%CI=0.268-0.408, P <0.00011) through the meta-analysis. Sensitivity analysis did not provide significant results (R=0.358 R2=0.128 p<0.469). CONCLUSIONS: The protective role of Pap test against cervical cancer has been confirmed especially among women <40 years. Annual screening still remains the most cost-effective preventive strategy.
Entities:
Keywords:
Cervical cancer; Meta-analysis; Metaregression; Pap test; Screening
Authors: Sandi L Pruitt; Claudia L Werner; Eric K Borton; Joanne M Sanders; Bijal A Balasubramanian; Arti Barnes; Andrea C Betts; Celette Sugg Skinner; Jasmin A Tiro Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-09-05 Impact factor: 4.254
Authors: Alejandra Castanon; Aruna Kamineni; K Miriam Elfström; Anita W W Lim; Peter Sasieni Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-09-14 Impact factor: 4.254
Authors: Johannes Horn; Agnieszka Denecke; Alexander Luyten; Beate Rothe; Axel Reinecke-Lüthge; Rafael Mikolajczyk; Karl Ulrich Petry Journal: Br J Cancer Date: 2019-04-16 Impact factor: 7.640
Authors: Mariana T Rezende; Raniere Silva; Fagner de O Bernardo; Alessandra H G Tobias; Paulo H C Oliveira; Tales M Machado; Caio S Costa; Fatima N S Medeiros; Daniela M Ushizima; Claudia M Carneiro; Andrea G C Bianchi Journal: Sci Data Date: 2021-06-10 Impact factor: 6.444