Abstract 63: Barriers and Facilitators of Cervical Cancer Screening Access in Belize: A Qualitative Analysis of Stakeholder Perspectives

Abstract

Abstract Purpose: Cervical cancer is the fourth most common cancer among women worldwide. Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries despite current programs to increase access to secondary prevention services. This study evaluates the perspectives of key stakeholders in the cervical cancer screening system in Belize to elucidate barriers and facilitators of cervical cancer screening services. Methods: In 2018, semi-structured interviews discussing challenges and successes in cervical cancer screening were conducted with key stakeholders across the 6 districts of Belize. Interviews were transcribed and coded using thematic content analysis to identify salient themes. Themes were organized by levels of the Tappan model. Results: A total of 47 interviews were conducted with healthcare providers (45%), administrators (17%), government officials (25%), and other stakeholders (13%). 78% of interviews were conducted in the public sector. Perceived barriers to cervical cancer screening were identified across 5 levels: (1) Individual (expectation of delay in Pap smear results and fear of a cancer diagnosis, reduces participation in screening); (2) Provider (responsibilities beyond the provision of screening service prevents clinics from offering services daily); (3) Organizational (insufficient space and training engenders diagnostic delays and possible misdiagnoses); (4) Community (screening limitations are more pronounced in rural vs. urban areas); and (5) Policy (limited budget allocated to equipment and staff restricts screening coverage). Salient facilitators were identified at the community and policy levels. At the community level, facilitators included resource-sharing between public and private sectors and the designation of personnel for rural outreach. Facilitators at the policy level included government coverage of screening costs and establishment of population-based screening targets. Conclusion: Despite no-cost cervical cancer screening in Belize, barriers still exist. Overloaded provider responsibilities, geographic inaccessibility, and insufficient funding are insights that serve as potential areas for system strengthening. Citation Format: Avni Mittal, Shane Neibart, Abha Kulkarni, Taylor Anderson, Jennifer Tsui, Shawna Hudson, Mark Einstein, Natalia Largaespada Beer, Racquel E. Kohler. Barriers and Facilitators of Cervical Cancer Screening Access in Belize: A Qualitative Analysis of Stakeholder Perspectives [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 63.