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Although systematic reviews aim to increase transparency and rigor in health evaluations for public health decision-making, some methodologies have been criticized for being algorithmic, maladapted to the complexity and diversity of environmental and occupational epidemiology studies, or misused by reviewers without adequate expertise. Need for continual methods refinement has prompted both the development and updated RoC handbook.

The RoC handbook provides guidance to conduct systematic reviews and integrate evidence to identify cancer hazards. Evaluating the informativeness of epidemiological studies focuses on the direction, magnitude, and impact of biases and study sensitivity. Updates to the RoC handbook, which will be peer reviewed and published as a living document, are based on its application to 7 RoC and 3 OEHHA cancer hazard evaluations and …