Purpose For Colombian women, breast and cervical cancer are the leading causes of mortality, despite being potentially curable through early detection and timely treatment. Tedious administrative processes and a lack of cancer screening education and awareness hinders early detection. Mobile applications (mApps) have permeated all levels of society and are potential tools by which to deliver personalized information and identify high-risk patients in need of screening tests thereby improving early cancer detection. The aim of this work is to create a free mApp that educates and guides patients to the national screening programs for breast and cervical cancer. Methods An mApp Amate was advertised to women (age ≥ 14 years) in the waiting rooms of a health care facility of a community hospital during a period of 9 months. Amate used educational, evaluative, and risk factor questions to measure the population’s knowledge of breast and cervical cancer. Each question was followed by an explanation. Correct answers yielded points that were redeemable for cellular data. Risk assessment questions identified women who required screening who were subsequently contacted by a health care provider and enrolled in the national cancer care program. Results A total of 4,553 women were contacted from August 2017 to May 2018. Of this group, 830 downloaded Amate and answered all of the questions. On the basis of the risk factor questions, 16% of patients (n = 131) were identified as being at risk for breast and/or cervical cancer and needed to be enrolled in the national screening program. Thus far, 24% of patients (n = 32) have successfully completed their recommended screening tests—mammogram, Papanicolau smear, or both. We also identified specific barriers to enrolling patients in these programs, including an unwillingness to be enrolled, limited available appointments at health care centers, and denied access as a result of health care coverage. Conclusion Amate is a low-cost, accessible tool that identifies women who are at risk for breast and cervical cancer and detects access barriers to early cancer detection. Administrative obstacles still exist and must be addressed to improve early cancer detection and screening. Amate has the potential to reach people from rural areas of Colombia and other underserved countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Armando Sardi Stock or Other Ownership: Celgene, Johnson & Johnson Mavalynne Orozco-Urdaneta Employment: Partners For Cancer Care And Prevention Foundation, Stamina-in-Action Stock or Other Ownership: Celgene, Johnson & Johnson Luis Gabriel Parra-Lara Research Funding: Merk & Co
A new method to address verification bias in studies of clinical screening tests: cervical cancer screening assays as an example
