Nathanael Yong

and 8 more

Background: Cervical cancer affects 3,197 women in the UK, and 604000 women worldwide annually, with peak incidence seen between 30-34 years of age. For many, fertility-sparing surgery is an appealing option where possible. However, absence of large-scale data, along with a notable variation in reported outcomes in relevant studies may undermine future efforts for consistent evidence synthesis. Objectives: To systematically review the reported outcomes measured in studies that include women who underwent fertility-sparing surgery for cervical cancer and identify whether variation exists. Search Strategy: We searched MEDLINE, EMBASE, and CENTRAL from inception to February 2019. Selection Criteria: Randomised controlled trials, cohort and observational studies, and case studies of more than 10 participants from January 1990 to date. Data Collection and Analysis: Study characteristics and all reported treatment outcomes. Main results: 104 studies with a sum of 9535 participants were identified. Most studies reported on oncological outcomes (97/104), followed by fertility and pregnancy (86/104), post-operative complications (74/104), intra-operative complications (72/104), and quality of life (5). There were huge variation and heterogeneity in reported outcomes, with only 12% being good quality and 87% being of poor quality. Conclusions: There is significant heterogeneity in the reported outcomes. An agreed Core Outcome Set (COS) is necessary for future studies to effectively harmonise reported outcomes that are measurable and relevant to patients, clinicians, and researchers. This systematic review sets the groundwork for the development of a COS for fertility sparing surgery in cervical cancer. Funding: British Medical Association’s Strutt and Harper Grant.

Neha Shah

and 5 more

Objective To explore patients’ attitudes and acceptability of universal screening for COVID-19 in a maternity population. Design Pre-screening and post-screening patient surveys Setting London Population Women admitted to the Maternity Unit at Newham Hospital during a two-week trial period of universal screening. Methods Cluster random sampling was used to select participants to complete the pre-screening questionnaire. Post-screening questionnaires were performed over the telephone. Main outcome measured Agreement to statements regarding patient’s acceptability of the SARS-CoV-2 screening test and the impact screening had on the care provided to themselves and their babies. Results During the two-week period, 180 women underwent universal screening. 81 participants completed the pre-screening questionnaire and 79 participants completed the post-screening survey (72-85% completion rate). More than 70% of women agreed that routine screening resulted in a positive effect on their care, the care of their babies and on their families. More than 80% of women agreed that they would be happy with their care if all pregnant women were offered testing for COVID-19 on admission to hospital. However, 50.62% of women agreed that having a COVID-19 screening swab test taken was uncomfortable and 35.80% were worried about the test results. Nulliparous women were more likely to perceive the positive impacts of screening on their care, their babies care, and their families as compared to multiparous women. Conclusion Our study provides evidence that patient acceptability and tolerance to COVID-19 screening is high, which is key for future implementation of universal screening across maternity services in the UK.