Criterion | Inclusion | Exclusion |
---|---|---|
Population | Individuals with a cervix, 15 years of age and older, who have been sexually active, and who have no symptoms of cervical cancera Population subgroups: – By age group (15–19, 20–24, 25–29, 30–69, 70+) – Risk groups: immunocompromised (e.g. HIV, organ transplantation, chemotherapy or chronic use of corticosteroids, use of disease-modifying anti-rheumatic drugs or biologics); risk behaviours (e.g. early sexual debut, women who have sex with women, individuals who have multiple sexual partners, smoking); under or never screened (e.g. transgender individuals, individuals with a history of trauma or abuse); Indigenous peoples; rural populations; immigrants; race or ethnicity; low socioeconomic status; pregnant individuals; HPV-vaccinated populations | Study population includes > 25% individuals with recent abnormal screening result |
Intervention | Any screening strategy using hrHPV tests and/or cytology with subsequent follow-up of abnormal tests: – Primary screening with cytology (conventional or liquid-based) – Primary screening with hrHPV testing – Cytology screening, which if abnormal may be followed by triage with an hrHPV test – hrHPV screening, which if positive may be followed by triage with cytology or other hrHPV test (e.g. full genotyping) – Other combinations will be considered | HPV test using in situ hybridization, p16 immunostaining, or HPV viral load Urine for sample collection Point-of-care tests Co-testing as a strategy (although we will include relevant data for the individual strategies where suitable) |
Comparator | Effectiveness: No routine screening Comparative effectiveness: Any screening strategy differing by one or more of the following factors: – Screening test strategy – Screening interval – Universal vs. selective/targeted (e.g. starting age) – Method of sample collection (e.g. self-collectionb (self-collection at home vs. self-collection in clinic) vs. health provider collection) – Protocol for evaluation of abnormal screening results (e.g. criteria for immediate colposcopy) |  |
Outcomes | Critical outcomes: – Incidence of invasive cervical cancer (squamous and adenocarcinoma) – Incidence of cervical intraepithelial neoplasia (CIN) 2 and CIN 3c – Cervical cancer mortality – All-cause mortality – Overdiagnosis of CIN 2 and CIN 3 and invasive cervical cancerc Important outcomes: – Number and rates of colposcopy and/or biopsy, including LEEP and other treatments provided during colposcopy (or referral rate) (for comparative effectiveness) – Adverse pregnancy outcomes from conservative, local management of CIN – False-positive rate for detecting CIN 2 and CIN 3 and invasive cancerc |  |
Timing | No limitation on the duration of follow-up; results will be reported by screening round and longest follow-up | Â |
Setting | Studies from Very High Human Development Index countries | Â |
Study design | – Randomized controlled trials – If insufficient data from randomized controlled trials (by comparison and outcome): non-randomized studies (controlled trials, before-after studies, interrupted time series, individual patient data meta-analysis, cohort studies, case-control studies) | Conference proceedings; government reports; systematic reviews; case reports; editorials |
Language | English or French | Â |
Publication date | 1995–present |  |