A systematic literature review of the effectiveness of community-based strategies to increase cervical cancer screening.

To evaluate and summarize evidence of the effectiveness of interventions available to public health staff that could be used to increase cervical cancer screening to women.A thorough literature review was conducted, articles screened for relevance and assessed for quality.Of 42 relevant studies, 1 was rated 'strong', 18 'moderate' and 23 'weak'. Among the strong/moderate studies, 10 were aimed at disadvantaged women. The most frequently used intervention was mass media campaigns, alone or combined with individual strategies; followed by individual education using lay health educators; and last, letters of invitation. Thirteen of the moderate/strong studies evaluated strategies that reported statistically significant increases in Pap smear rates and other outcomes.Strategies that combined mass media campaigns with direct tailored education to women and/or health care providers seemed most successful. The importance of accurate centralized cytology databases for recall is underscored.