Journal of evaluation in clinical practice
Quality Disparities and Recommendation Consistency of Cervical Cancer Screening Guidelines: A Systematic Appraisal With the AGREE II Instrument
By Liao X, Liu Y, Tang Y and 1 others.
Abstract
Background
Cervical cancer remains a leading global public health threat. Standardised, high-quality clinical practice guidelines (CPGs) for cervical cancer screening are critical for early detection, standardised practice, and reducing disease burden.
Objectives
This systematic appraisal evaluated the methodological quality and recommendation consistency of cervical cancer screening CPGs published in the past decade, focusing on recent updates from the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG). Search strategy: A systematic search was performed in PubMed, Embase, the Evidence-Based Medicine Clinical Practice Guidelines Database, and NICE. Eligible CPGs were published between December 2010 and June 2026. Selection criteria: Eight eligible guidelines were included (7 official CPGs and 1 consensus statement), developed by institutions in 4 countries across 3 continents, with publication years ranging from 2012 to 2026. Data collection and analysis: Two researchers independently evaluated all CPGs using AGREE II across six domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence. Main results: Eight eligible guidelines were included (SOGC 2012, ASCCP/SGO 2015, USPSTF 2018, WHO 2021, CSCCP 2023, ACS 2025, CACA 2025, and ACOG 2026). Standardised average scores for the six domains were 81.2%, 70.8%, 63.5%, 81.2%, 56.7%, and 72.9%. Three CPGs (WHO 2021, ACS 2025, and ACOG 2026) were rated Level A; the remaining five were rated Level B. Major inconsistencies were noted in screening initiation age and self-collected HPV testing.