Digital tools to enhance adherence to cervical cancer prevention practices: systematic review
Frontiers in Public Health, cilt.14, 2026 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 14
- Basım Tarihi: 2026
- Doi Numarası: 10.3389/fpubh.2026.1851751
- Dergi Adı: Frontiers in Public Health
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, EMBASE, MEDLINE, Psycinfo, Directory of Open Access Journals
- Anahtar Kelimeler: artificial intelligence, cervical cancer screening, chatbots, HPV vaccination, mobile health, serious games, systematic review
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Kocaeli Üniversitesi Adresli: Evet
Özet
Background – Human papillomavirus (HPV) vaccination and regular cervical screening are fundamental pillars of the World Health Organization (WHO) strategy to eliminate cervical cancer. While conventional one-way digital notifications moderately support preventive uptake, the specific behavioral impact of two-way, interactive patient-facing digital assistants-such as conversational artificial intelligence (AI) and gamified health applications-warrants rigorous, isolated synthesis. Objective – To systematically assess whether patient-facing interactive digital assistants are associated with improved initiation and completion of HPV vaccination and cervical cancer screening, strictly distinguishing between formative usability evidence and clinical effectiveness. Methods – Following PRISMA 2020 guidelines and PROSPERO registration (CRD420261333651), six academic databases were systematically searched (January 1, 2016–February 10, 2026). Eligible interventions were limited to interactive patient-facing digital tools. Data synthesis utilized a structured narrative approach, applying the Mixed Methods Appraisal Tool (MMAT 2018) for individual domain risk of bias and GRADE principles for evidence certainty. Results – The synthesis included 14 reports representing 13 independent studies. Formative evaluations indicated high usability and user acceptability. Within behavioral trials, conversational AI chatbots showed promising effects for short-term increases in HPV vaccine appointment booking (Moderate certainty). However, multi-dose series completion remained severely constrained by high attrition rates (Low certainty). For secondary prevention, theory-based apps were associated with enhanced short-term cytology uptake (Moderate certainty). A serious game correlated with a higher diagnostic rate of cervical precancer (CIN2+); however, profound uncontrolled confounding limits causal attribution. Conclusion – Interactive patient-facing digital assistants may improve short-term appointment scheduling and screening participation. Nevertheless, the current literature is heavily constrained by self-selection, attrition, and the inability to isolate the effects of multicomponent interventions. Future pragmatic trials are essential to replicate these findings. Systematic review registration – https://www.crd.york.ac.uk/PROSPERO/view/CRD420261333651, CRD420261333651.