Mapping interventions to increase uptake of breast and cervical cancer screening along the Intervention Ladder: a systematic review.

In 30 seconds

This systematic review classified interventions to increase breast and cervical cancer screening uptake among under-screened women using the Intervention Ladder framework. It included randomised and cluster-randomised trials targeting women who had never been screened, were overdue, or had not responded to screening invitations. Of 2,981 records identified, 91 trials met the inclusion criteria. Because interventions, populations, and outcome reporting varied substantially, the authors used narrative synthesis. Low-intensity approaches supporting individual autonomy, including mailed reminders and self-sampling kits, were consistently effective; more intrusive approaches showed no clear added benefit.

Key findings

• The review included 91 randomised or cluster-randomised trials of interventions for under-screened women.
• Low-intensity strategies, including mailed reminders and self-sampling kits, were consistently effective in increasing screening uptake.
• More intrusive interventions were infrequently implemented and showed no clear added benefit.

Why it matters

The findings suggest that screening participation can be supported with accessible, autonomy-preserving approaches rather than assuming that more intensive or intrusive interventions are more effective. The review also highlights the need to consider ethical proportionality when designing programmes to reach women who are overdue or have not previously participated.

What to keep in mind

Substantial heterogeneity in intervention types, populations, and outcome reporting prevented quantitative synthesis; results were summarised narratively.