***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Our objective was to assess the efficiency of a home-visit invitation aim ed to increase uptake of cervical cancer screening in women between 35 and 60 years of age . From May , 2006 , we conducted a quasi-r and omized trial to determine if an in-home education and invitation intervention would increase uptake of cervical cancer screening . We r and omly recruited 304 women from the Samliem inner-city community , Khon Kaen , Northeast Thail and , and assigned participants to either the intervention or control zone . Baseline screening coverage interviews were then performed : 58 of 158 women in the intervention zone and 46 of 146 in the control zone were excluded from the study because of having had a Pap smear within 5 years , but these were included in the final analysis . First , 100 women in the intervention group were visited in their homes by one of the research ers , who provided culturally-sensitive health education that emphasized the need for screening . Four months later , post-intervention ,  screening-coverage interviews were again performed in both groups , in combination with the same health education for 100 women in the control group for a comparison . There was no difference in the baseline Pap smear screening-coverage rate in the intervention vs. control zones ( 36.7 vs. 31.5 % , p=0.339 ) . One hundred women in the intervention group completed the intervention interviews and after four months , 100 women in the intervention group and 100 in the control group also completed the post-intervention interviews . The increased screening-coverage rate in the intervention zone was similar to that of the control zone ( 43.6 vs. 34.9 % , p=0.119 ) ; however , there was a borderline significant increase in the intervention zone compared with baseline ( 36.7 to 43.6 % , p=0.070 ) . Therefore , home visit education and invitation intervention produced only a nominal effect on increasing Pap smear coverage within a 4-month study period Background : Cervical cancer is a significant health disparity among women in Ohio Appalachia . The goal of this study was to evaluate the efficacy of a lay health advisor ( LHA ) intervention for improving Papanicolaou ( Pap ) testing rates , to reduce cervical cancer , among women in need of screening . Methods : Women from 14 Ohio Appalachian clinics in need of a Pap test were r and omized to receive either usual care or an LHA intervention over a 10-month period . The intervention consisted of two in-person visits with an LHA , two phone calls , and four postcards . Both self-report and medical record review ( MRR ) data ( primary outcome ) were analyzed . Results : Of the 286 women , 145 and 141 were r and omized to intervention and usual care arms , respectively . According to MRR , more women in the LHA arm had a Pap test by the end of the study compared with those r and omized to usual care ( 51.1 % vs. 42.0 % ; OR = 1.44 , 95 % CI : 0.89–2.33 ; P = 0.135 ) . Results of self-report were more pronounced ( 71.3 % vs. 54.2 % ; OR = 2.10 , 95 % CI : 1.22–3.61 ; P = 0.008 ) . Conclusions : An LHA intervention showed some improvement in the receipt of Pap tests among Ohio Appalachian women in need of screening . Although biases inherent in using self-reports of screening are well known , this study also identified biases in using MRR data in clinics located in underserved areas . Impact : LHA interventions show promise for improving screening behaviors among nonadherent women from underserved population s. Cancer Epidemiol Biomarkers Prev ; 20(5 ) ; 835–43 . © 2011 AACR OBJECTIVES We compared the effectiveness of a telephone outreach approach versus a direct mail approach in improving rates of colorectal cancer ( CRC ) screening in a predominantly Black population . METHODS A r and omized trial was conducted between 2000 and 2003 that followed 456 participants in the New York metropolitan area who had not had recent CRC screening . The intervention group received tailored telephone outreach , and the control group received mailed printed material s. The primary outcome was medically documented CRC screening 6 months or less after r and omization . RESULTS CRC screening was documented in 61 of 226 ( 27.0 % ) intervention participants and in 14 of 230 ( 6.1 % ) controls ( prevalence rate difference=20.9 % ; 95 % CI = 14.34 , 27.46 ) . Compared with the control group , the intervention group was 4.4 times more likely to receive CRC screening within 6 months of r and omization . CONCLUSIONS Tailored telephone outreach can increase CRC screening in an urban minority population Objective : Despite the proven survival benefits associated with cervical cancer screening , use of the Pap test continues to be suboptimal in some population subgroups , such as among Korean-American women who face considerable barriers to screening . Therefore , we evaluated a multifaceted intervention that combined psychoeducational counseling with patient navigation to address both psychosocial and access barriers to screening . Method : Women ( n = 102 ) were recruited from Korean community centers and assigned to the intervention or control condition . The intervention group received cervical cancer education and patient navigation delivered by bilingual Korean health educators . The control group received general health education , including information about cervical cancer and screening . Assessment s were obtained at baseline and postintervention . Screening behavior was assessed at 6 months postintervention . Results : At baseline , 17 % of participants reported having had a Pap test in the previous year . At 6 months postintervention , 83 % of women in the intervention group had obtained screening compared with 22 % in the control group , χ2(1 ) = 41.22 , P < 0.001 . Multivariate logistic regression analyses indicated that participation in the intervention was associated with screening ( P < 0.001 ) . Fewer psychosocial barriers ( e.g. , discomfort at having a stranger perform Pap ) and greater self-efficacy were also associated with screening ( P < 0.05 ) . Conclusion : A combined modality intervention that delivers education with patient navigation training and assistance result ed in increased screening rates . Multifaceted approaches may be effective in reducing the psychosocial , access , and language barriers that contribute to cancer health disparities in underserved population s. ( Cancer Epidemiol Biomarkers Prev 2007;16(6):1–5 OBJECTIVES Although cervical cancer is one of the potentially most preventable malignancies , it is still fairly common . In setting s with established screening programs , increased compliance is important for future reduction in cervical cancer incidence , but it is presently unclear how this can be effectively achieved . METHODS We conducted a r and omized controlled trial including all 12,240 women invited to organized screening in Sweden . To increase compliance , three successive interventions were tested : ( a ) modified invitation versus the st and ard invitation letter , ( b ) reminder letter to nonattenders after the first intervention versus no reminder letter , and ( c ) phone reminder to nonattenders after the reminder letter versus no phone reminder . We analyzed the proportion of women attending screening after each intervention and the cumulative proportion after the interventions as well as the cumulative proportions of cytologic abnormalities . RESULTS The modified invitation did not increase attendance compared with the st and ard invitation letter [ difference 1.3 % 95 % confidence interval ( CI ) -0.3 to 2.9 ] . In contrast , a reminder letter increased the proportion of women attending with 9.2 % ( 95 % CI 7.9 - 10.5 ) compared with women who did not receive a reminder letter , and a phone reminder increased the proportion of women attending with 31.4 % ( 95 % CI 26.9 - 35.9 ) . Combinations of modified invitation , written reminder , and phone reminder almost doubled attendance within 12 months , and the number of detected cytologic abnormalities was more than tripled . CONCLUSIONS Simple reminders by mail and phone can drastically increase women 's participation in Papanicolaou smear screening and increase the number of detected precursor lesions and thereby save lives A r and omized trial was conducted to evaluate the combined impact of a physician reminder letter and a telephone contact on the use of Pap tests and mammograms in a low-income managed care program . Women 40 to 79 years of age who were past due for cancer screening were r and omly assigned to an intervention or control group . Medical cl aims were review ed after 6 months to determine intervention effectiveness . The odds of receiving all needed cancer screening tests during follow-up were four times higher in the intervention group . Women who reported having to take time off from work to see a doctor had lower odds of getting screened BACKGROUND We determined whether testing of self-collected vaginal swabs for human papillomavirus ( HPV ) DNA can be used to screen for cervical disease within internal medicine outpatient clinics . PATIENTS AND METHODS In this prospect i ve study , 560 patients visiting two referral outpatient clinics for internal medicine were asked to take an HPV self- sample .  Acceptability of self sampling , HPV prevalence and cervical intraepithelial neoplasia ( CIN ) detection rate were evaluated . RESULTS 435 women ( 78 % ) performed HPV self-sampling ; 1.5 % considered self-sampling to be difficult . 134 women ( 31 % ) tested positive for high-risk type of HPV . There were significant differences between HPV-positive and -negative women with respect to the following : mean age ( 42 versus 46 years ) , number of women aged < 16 years at first coitus ( 35 % versus 23 % ) and history of drug abuse ( 8.3 % versus 2.6 % ) . Colposcopy could be performed for 70 HPV positive women : CIN 1 - 3 was identified in 24 % . Two of 52 women with HPV-negative results undergoing colposcopy had biopsy-confirmed CIN 1 . Test performance for detection of CIN 2 - 3 after correction for verification bias : sensitivity , 100 % ; specificity , 71 % ; negative predictive value , 100 % ; positive predictive value , 10 % . HPV persistence was associated with a 5.7-fold risk of CIN 2 - 3 detection at follow-up . CONCLUSIONS Self- assessment for HPV DNA is an easy , feasible and well-accepted method for HPV testing and for cervical cancer screening in internal medicine outpatient clinics BACKGROUND North American Chinese women have lower levels of Papanicolaou ( Pap ) testing than other population subgroups . We conducted a r and omized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America . METHODS Four hundred and eighty-two Pap testing underutilizers were identified from community-based surveys of Chinese women conducted in Seattle , Washington , and Vancouver , British Columbia . These women were r and omly assigned to one of two experimental arms or control status . Several Chinese- language material s were used in both experimental arms : an education-entertainment video , a motivational pamphlet , an educational brochure , and a fact sheet . Women in the first experimental group ( outreach worker intervention ) received the material s , as well as tailored counseling and logistic assistance , during home visits by trilingual , bicultural outreach workers . Those in the second experimental group ( direct mail intervention ) received the material s by mail . The control group received usual care . Follow-up surveys were completed 6 months after r and omization to ascertain participants ' Pap testing behavior . All statistical tests were two-sided . RESULTS A total of 402 women responded to the follow-up survey ( 83 % response rate ) . Of these women , 50 ( 39 % ) of the 129 women in the outreach group , 35 ( 25 % ) of the 139 women in the direct mail group , and 20 ( 15 % ) of the 134 women in the control group reported Pap testing in the interval between r and omization and follow-up data collection ( P<.001 for outreach worker versus control , P = .03 for direct mail versus control , and P = .02 for outreach worker versus direct mail ) . Intervention effects were greater in Vancouver than in Seattle . CONCLUSION Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America OBJECTIVES We sought to promote cervical cancer screening among Vietnamese American women in Santa Clara County , Calif. METHODS In 2001 - 2004 , we recruited and r and omized 1005 Vietnamese American women into 2 groups :  lay health worker outreach plus media-based education ( combined intervention ) or media-based education only . Lay health workers met with the combined intervention group twice over 3 to 4 months to promote Papanicolaou ( Pap ) testing . We used question naires to measure changes in awareness , knowledge , and Pap testing . RESULTS Testing increased among women in both the combined intervention ( 65.8 % to 81.8 % ; P<.001 ) and media-only ( 70.1 % to 75.5 % ; P<.001 ) groups , but significantly more in the combined intervention group ( P=.001 ) . Among women never previously screened , significantly more women in the combined intervention group ( 46.0 % ) than in the media-only group ( 27.1 % ) obtained tests ( P<.001 ) . Significantly more women in the combined intervention group obtained their 
    Output:
    
Both review s have found varying success using lay health advisors , with the majority of included papers reporting a statistically significant increase in screening uptake .
HPV self-testing can improve uptake of cervical cancer screening among lower socioeconomic groups .
The findings of this up date d review largely support that of the 2006 review for the use of lay health advisors