Community-Based Screening for Cervical Cancer: A Feasibility Study of Rural Appalachian Women
Published Date:Nov 2015
Source:Sex Transm Dis. 42(11):607-611.
Cervical Cancer Screening
Early Detection Of Cancer
Medically Underserved Area
Patient Acceptance Of Health Care
Uterine Cervical Neoplasms
Pubmed Central ID:PMC4608378
Funding:R01 MH092226/MH/NIMH NIH HHS/United States
U48 DP001932/DP/NCCDPHP CDC HHS/United States
U48 DP005014/DP/NCCDPHP CDC HHS/United States
1U48DP001932-01/DP/NCCDPHP CDC HHS/United States
To describe women’s comfort levels and perceptions about their experience self-collecting cervico-vaginal swabs for HPV testing; to determine whether nurse-guided patient navigation increases the odds of women receiving a traditional Pap test after HPV screening; and to test the hypothesis that women testing positive for oncogenic HPV would be more likely to have a subsequent Pap test than those testing negative.
400 women were recruited from eight rural Appalachian counties, in 2013 and 2014. After completing a survey, women were provided instructions for self-collecting a cervico-vaginal swab. Specimens were tested for 13 oncogenic HPV types. Simultaneously, women were notified of their test results and offered initial navigation for Pap testing. Chart-verified Pap testing within the next six months served as the endpoint.
Comfort levels with self-collection were high: 89.2% indicated they would be more likely to self-collect a specimen for testing, on a regular basis, compared to Pap testing. Thirty women (7.5%) had a follow-up Pap test. Women receiving added nurse-guided navigation efforts were significantly less likely to have a subsequent test (P = .01). Women testing positive for oncogenic HPV were no more likely than those testing negative to have a subsequent Pap test (P = .27). Data were analyzed in 2014.
Rural Appalachian women are comfortable self-collecting cervico-vaginal swabs for HPV testing. Further, efforts to re-contact women who have received an oncogenic HPV test result and an initial navigation contact may not be useful. Finally, testing positive for oncogenic HPV may not be a motivational factor for subsequent Pap testing.
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