The impact on women’s health and the cervical cancer screening budget of primary HPV screening with dual-stain cytology triage in Belgium

Background: Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. Trained nurses provide fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment of reproductive tract infections (RTI) and refer for further tests and treatment indicated. Methods: We retrospectively reviewed and analyzed WHP medical records from women who presented for cervical cancer screening from 2007-2014. Results: In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment of RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. Conclusion: The WHP's experience using a cost-recovery model and offering multiple services in a single clinic rather than stand-alone cervical cancer screening may be a practical model to make cervical cancer screening services accessible, comprehensive and sustainable. Integrating other women's health services enabled women to address additional health care needs.

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Recovery strategies following COVID-19 disruption to cervical cancer screening and their impact on excess diagnoses

British Journal of Cancer ◽

10.1038/s41416-021-01275-3 ◽

2021 ◽

Author(s):

Alejandra Castanon ◽

Matejka Rebolj ◽

Francesca Pesola ◽

Peter Sasieni

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Intraepithelial Neoplasia ◽

Cervical Cancers ◽

Screening Interval ◽

Recovery Strategies ◽

Screening Services ◽

The Impact ◽

Published Research

Abstract Background The COVID-19 pandemic has disrupted cervical cancer screening services. Assuming increases to screening capacity are unrealistic, we propose two recovery strategies: one extends the screening interval by 6 months for all and the other extends the interval by 36/60 months, but only for women who have already missed being screened. Methods Using routine statistics from England we estimate the number of women affected by delays to screening. We used published research to estimate the proportion of screening age women with high-grade cervical intraepithelial neoplasia and progression rates to cancer. Under two recovery scenarios, we estimate the impact of COVID-19 on cervical cancer over one screening cycle (3 years at ages 25–49 and 5 years at ages 50–64 years). The duration of disruption in both scenarios is 6 months. In the first scenario, 10.7 million women have their screening interval extended by 6 months. In the second, 1.5 million women (those due to be screened during the disruption) miss one screening cycle, but most women have no delay. Results Both scenarios result in similar numbers of excess cervical cancers: 630 vs. 632 (both 4.3 per 100,000 women in the population). However, the scenario in which some women miss one screening cycle creates inequalities—they would have much higher rates of excess cancer: 41.5 per 100,000 delayed for screened women compared to those with a 6-month delay (5.9 per 100,000). Conclusion To ensure equity for those affected by COVID-19 related screening delays additional screening capacity will need to be paired with prioritising the screening of overdue women.

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Evaluation of a Narrative Video to Promote Prevention and Early Detection of Cervical Cancer Among Latinas

Health Promotion Practice ◽

10.1177/15248399211038943 ◽

2021 ◽

pp. 152483992110389

Author(s):

Jessica Calderón-Mora ◽

Adam Alomari ◽

Theresa L. Byrd ◽

Navkiran K. Shokar

Keyword(s):

Cervical Cancer ◽

Social Media ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Program ◽

Psychosocial Variables ◽

Eligibility Criteria ◽

Cancer Risk Factors ◽

Efficacy Analysis ◽

The Impact

Objective To evaluate the impact of an online-delivered, theory-based narrative video on cervical cancer screening knowledge, attitudes, and beliefs in a predominantly Latino community. Methods The study design was a nonrandomized pretest–posttest evaluation. The eligibility criteria included men and women 18 years or older not previously enrolled in our community cervical cancer screening program who had internet access. Participants were recruited via in-person county-wide flyer distribution and social media dissemination. The intervention involved a narrative video designed for Latinas delivered via the internet. The 17-minute video is novella style, with a culturally tailored storyline and setting that covers cervical cancer risk factors and statistics, importance of screening, and addresses testing barriers. The measures were knowledge about cervical cancer and screening, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, subjective norms, and self-efficacy. Analysis was performed using change scores for knowledge and psychosocial variables and descriptive statistics for satisfaction and acceptability of the video. Results Data from 227 surveys were analyzed; respondent mean age: 37.6 years; 98.8% female, 88.8% Hispanic; 42.0% had an annual income of $20,000 or less; and 85.2% had at least a high school education. Knowledge and all psychosocial variables improved significantly. More than 90% of the participants rated all of the satisfaction items as good or excellent. Conclusions and Implications for Practice A culturally appropriate narrative video about cervical cancer and screening disseminated online effectively improved knowledge and psychosocial variables among Latinas. Our findings indicate that health promotion interventions online could be effective for improving desired health behavior through a new means of educational dissemination by way of websites and social media outlets.

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