Barriers To Cervical Cancer Screening Research Articles

Barriers to Cervical Cancer Screening Among Women Living With HIV in Low- and Middle-Income Countries: A Systematic Review.

Women living with HIV in low-and-middle-income countries (LMICs) are at high risk of developing cervical cancer due to their immunocompromised status. Screening is an imperative prevention measure for early detection and for ultimately reducing high rates of cervical cancer; however, cervical cancer screening uptake among this group remains low. This systematic review aimed to identify barriers to cervical cancer screening among women living with HIV in LMIC. A comprehensive literature search was undertaken, and an analysis of included studies was completed to abstract major themes related to cervical cancer screening barriers for women living with HIV in LMIC. Lack of cervical cancer and cervical cancer screening knowledge among patients was found to be the most prevalent barrier to cervical cancer screening. Our findings highlight a dire need for interventions to increase knowledge and awareness of cervical cancer screening among women living with HIV in LMIC, along with addressing barriers within health care systems.

Abstract B101: Assessment and resolution of breast and cervical cancer screening barriers for underserved women in Louisiana

Abstract The Louisiana Breast and Cervical Health program (LBCHP) provides breast and cervical cancer screenings and navigation services at no cost to about 5,000 uninsured or underinsured women per year across the state. These low-income, uninsured or underinsured women have barriers that prevent them from receiving screenings and early cancer detection. A core part of the program is to provide navigation services to address these barriers to cancer care. LBCHP navigators provide extra layers of patient-centered education and resources to assist with completion of screening. They intervene on behalf of the patient with clinicians and departments to facilitate ease of navigating large systems. Navigators perform barriers assessments, both initial and ongoing, to anticipate problems and provide resources and support that lead to completion of screening and early cancer detection. This study analyzed the barriers and navigation services provided to 5,316 women at 12 LBCHP provider sites throughout Louisiana. The top five screening barriers identified by the women navigated over the phone were being uninsured (26%), needing information (17%), limited or inflexible appointment times (13%), long wait times (12%) and financial distress unrelated to health insurance (12%). Though cited as an important barrier in the literature, transportation issues ranked a distant 10th, with only 1% of women identifying it as a barrier. The barriers for women who completed screening services paid by LBCHP differed greatly from women who did not receive screening. The women who completed screening services listed their top barriers as uninsured (41%), needed information (20%) and non-English speaking (12%). In contrast, the women who did not receive screening listed their top barriers as financial distress unrelated to health insurance (42%) and screening was a low health priority (34%). The aforementioned two barriers were identified by 8% and 4%, respectively, of women who completed screening. Because cancer screening is a low health priority in Louisiana's unscreened population, it appears that women under financial distress would not prioritize cancer screening. The barriers will be presented by race/ethnicity, geographic location, insurance status and services provided. The results of this study suggest that financial distress is a difficult barrier to overcome and that barriers differ greatly by population. Services provided need to be tailored by the types of barrier encountered. Citation Format: Janet Brown, Nannozi Ssenkoloto, Tyler Bartley, Donna Williams. Assessment and resolution of breast and cervical cancer screening barriers for underserved women in Louisiana [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B101.

Knowledge, attitudes and barriers of cervical cancer screening among women in Chegutu rural district of Zimbabwe

Cervical cancer is the most common cancer among females in Zimbabwe, yet the screening rate remains low. Building on the knowledge, attitude and practice model, this study investigated the signs an...

Abstract 483: Perceived benefits and barriers towards cervical cancer screening among women >15 years in Arsi zone, Southeastern Ethiopia: Application of the Health Belief Model (HBM) in a community- based cross-sectional study

Abstract Introduction: The rate of cancer mortality is18.4 per 100,000 in Ethiopia, and cancer of the cervix is the second most common cancer, with an incidence of 16.4 per 100,000. Cancer of the cervix is easily prevented through vaccinations against HPV, regular screening and treatment. Assessing the perception of women with regard to the benefits and barriers of cervical cancer screening among women is important to decrease the barriers and increase the screening rate for early detection. The aim of this study was to describe women’s perceived benefits and barriers to cervical cancer screening and their associated factors in Arsi zone, southeastern Ethiopia. Methods: This community- based cross-sectional study design was conducted in Arsi zone, southeastern Ethiopia among 906 women aged >15 years using a multi-stage sampling technique. After data had been coded and entered into Epi info, it was exported into SPSS for analysis. A binary logistic regression model was used to determine associations between socio-demographic characteristics and reproductive variables on the knowledge of cervical cancer and perception of screening at a p-value of <0.05. Results: Most of the participants had higher perceptions of the benefits and barriers to screening (567(62.6%) and 487(53.8%), respectively). The women who would like to undergo cervical cancer screening in the future when the service was available were 2.6 times more likely to believe in the benefits of undergoing screening than those who did not wish to undergo screening [AOR=2.3, 95% CI: (1.2-4.6)]. Women living in rural areas were 4 times more likely to perceive the benefits of cervical cancer screening than those living in semi-urban areas [AOR=3.9, 95% CI: (1.9-7.7)]. Women who started sexual intercourse at age <16 years were 2 times more likely to perceive barriers to cervical cancer screening than those who started sexual intercourse at age >16 years [AOR=2.2, 95% CI: (1.5-3.3)]. Moreover, the women who had >3 children were 1.5 times more likely to perceive barriers to cervical cancer screening than those who had <3 children [AOR=1.5, 95% CI: (1.1-2.0)]. Conclusion and recommendation: There were high perceived benefits and barriers to screening in the community. We recommend decreasing the perceived barriers towards screening through education intervention and expanding screening services, as this can increase the uptake of screening in the community. Key word: Cervical Cancer, Screening, Perceived Benefits, Perceived Barrier, Health Belief Model 1 Note: This abstract was not presented at the meeting. Citation Format: Gemechu Chemeda Feyissa. Perceived benefits and barriers towards cervical cancer screening among women >15 years in Arsi zone, Southeastern Ethiopia: Application of the Health Belief Model (HBM) in a community- based cross-sectional study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 483.

“HIV is not an easily acceptable disease”: the role of HIV-related stigma in obtaining cervical cancer screening in India

ABSTRACTWomen living with HIV (WLWH) are at high risk for cervical cancer (CC); however, many WLWH in India do not obtain regular CC screening. Little is known about facilitators and barriers of CC screening in this population. This qualitative study examined the relation of HIV-related stigma to obtaining CC screening among women in Surat, India. Semi-structured individual in-depth interviews were conducted between April 2015 and July 2015 with 25 WLWH at the New Civil Hospital Anti-Retroviral Centre and 15 stakeholders providing health care to WLWH. HIV-related stigma emerged as a considerable barrier to gynecologic care and CC screening among WLWH. Two major subthemes were identified: (1) perceptions of HIV-related normative stigma and enacted discrimination; and (2) HIV status disclosure in the context of health care and CC screening. Stakeholders described a general awareness of HIV-related stigma as a barrier to care for WLWH, while WLWH focused on experiences of enacted discrimination. Both patients and stakeholders described that concerns about disclosure and fear of stigma hinder WLWH in India from obtaining health care and CC screening. Findings suggest that interventions to increase cancer screening among WLWH in India should address the role of HIV-related stigma to be maximally effective.

Perceived benefits and barriers toward cervical cancer screening among women ≥15 years in Arsi Zone, Southeastern Ethiopia: Application of the health belief model in a community-based cross-sectional study

Introduction: The rate of cancer mortality is18.4/100,000 in Ethiopia, and cancer of the cervix is the second-most common cancer, with an incidence of 16.4/100,000. Cancer of the cervix is easily prevented through vaccinations against human papilloma virus, regular screening, and treatment. Assessing the perception of women with regard to the benefits and barriers of cervical cancer screening among women is important to decrease the barriers and increase the screening rate for early detection. The aim of this study was to describe women's perceived benefits and barriers to cervical cancer screening and their associated factors in Arsi zone, Southeastern Ethiopia. Materials and Methods: This community-based cross-sectional study design was conducted in Arsi zone, Southeastern Ethiopia among 906 women aged >15 years using a multi-stage sampling technique. After data had been coded and entered into Epi info, it was exported into SPSS for analysis. A binary logistic regression model was used to determine associations between sociodemographic characteristics and reproductive variables on the knowledge of cervical cancer and perception of screening at a value of P < 0.05. Results: Most of the participants had higher perceptions of the benefits and barriers to screening (567 [62.6%] and 487 [53.8%], respectively). The women who would like to undergo cervical cancer screening in the future when the service was available were 2.6 times more likely to believe in the benefits of undergoing screening than those who did not wish to undergo screening (adjusted odds ratio [AOR] = 2.3, 95% confidence interval [CI]: [1.2–4.6]). Women living in rural areas were four times more likely to perceive the benefits of cervical cancer screening than those living in semi-urban areas (AOR = 3.9, 95% CI: [1.9–7.7]). Women who started sexual intercourse at age <16 years were two times more likely to perceive barriers to cervical cancer screening than those who started sexual intercourse at age >16 years (AOR = 2.2, 95% CI: [1.5–3.3]). Moreover, the women who had >3 children were 1.5 times more likely to perceive barriers to cervical cancer screening than those who had <3 children (AOR = 1.5, 95% CI: [1.1–2.0]). Conclusion and Recommendation: There were high perceived benefits and barriers to screening in the community. We recommend decreasing the perceived barriers toward screening through education intervention and expanding screening services, as this can increase the uptake of screening in the community.

Australian women's cervical cancer screening attendance as a function of screening barriers and facilitators

RationaleCervical cancer screening registry data indicate that 43% of eligible Australian women did not screen in the latest reporting period (2014–2015). However, few prior empirical studies have examined whether the screening barriers and facilitators experienced by women can affect their screening attendance. Such information is required to inform the development of future tailored health promotion strategies. ObjectiveThis study examined whether the cervical cancer screening barriers and facilitators identified by women were related to their screening history, from November 2015 and January 2016. At this time, Australian women typically undertook a Pap test every two years. They were deemed overdue for screening if they have not screened in the past 27 months (i.e., overdue by more than three months). MethodIn this study, a large sample (N = 338) of women were asked about their screening history including screening status (i.e., up-to-date vs. overdue) and prior screening (i.e., never screened vs. screened), and the psychological and practical screening barriers or facilitators they had experienced. ResultsLogistic regression analysis indicated that screening status was related to a greater number of psychological barriers, but not practical barriers or facilitators. In contrast, prior screening was related to more practical and psychological screening barriers and fewer practical facilitators, but not psychological facilitators. Some individual psychological screening barriers (e.g., anxiety, embarrassment), practical barriers (e.g., lack of time) and practical facilitators (e.g., low cost of test) were related to women's screening status and prior screening. ConclusionsResults suggest that addressing practical cervical cancer screening facilitators (e.g., reminder prompts) and psychological screening barriers may help to optimize screening attendance in women who have never screened or are overdue for cervical cancer screening.

Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis.

Eastern Africa has the highest rates of cervical cancer incidence (42.7 per 100,000) and mortality (27.6 per 100,000), substantially higher than worldwide incidence (14.0 per 100,000) and mortality (6.8 per 100,000). The purpose of this study was to explore facilitators and barriers to cervical cancer screening and human papilloma virus (HPV) vaccination among Somali refugee women and their children. Focus group discussions were conducted in August of 2016. Investigators performed systematic, comparative, and thematic data analyses. The 31 Somali refugee participants ranged from 23 to 64 years old. Four major themes emerged: (1) knowledge, (2) facilitators, (3) decision making, and (4) views on intervention strategies. Doctor recommendation and family support were important facilitators. Community education was the most popular strategy in promoting screening and vaccine uptake. Multilevel targeted interventions should increase knowledge and include family members to increase cervical cancer screening and HPV vaccination uptake in the Somali community.

Barriers and enablers for cervical cancer screening in the Pacific: A systematic review of the literature.

Background: Globally cervical cancer is the fourth most common type of cancer in women and in some low-income countries is the most common cancer in women. Papua New Guinea has a particularly concerning incidence of cervical cancer where it ranks first as the leading cause of cancer in females. Screening is a reliable strategy to detect cervical cancer but implementation of screening in Papua New Guinea is poor. The aim of this review is to identify the enablers and barriers for cervical cancer screening in Papua New Guinea.&#x0D; Methods: A systematic search of peer-reviewed literature was conducted using electronic databases; PubMed, Medline, Scopus, CINAHL and Google Scholar. Articles published between 2007 and 2017 that focused on the enablers and barriers to cervical cancer screening were included. Only one study from Papua New Guinea was identified so the search was extended to include other Pacific Island Countries and Low-Income Countries more broadly.&#x0D; Findings: Twenty articles met the inclusion criteria. The main barriers for cervical cancer screening included a lack of women’s knowledge about cervical cancer and screening, a lack of health facilities for screening, diagnosis and treatment, lack of health care worker knowledge and training, cultural beliefs and financial burdens. The main enablers included women having access to education programs, availability of cervical cancer screening services, female friendly environments and health care workers being trained to undertake screening.&#x0D; Conclusions: While the literature highlighted the importance of cervical cancer screening, a range of barriers limits the delivery of this service in low-income country settings. In particular, there is a gap in the knowledge of barriers and enablers within Papua New Guinea and further research in this country is required. Applying the knowledge learned from other low-income countries and gaining a clearer understanding of both the barriers and enablers for cervical cancer screening in the Papua New Guinea context may lead to clear recommendations to improve implementation and uptake of cervical cancer screening.

Impact of counseling on cervical cancer and its screening on women knowledge, health beliefs and protective practices

Background: Cervical cancer can be preventable or detected early especially with a series of regular screening with Pap tests.Aim of the study: The aim of this study were to evaluate the impact of counseling on cervical cancer and its screening on women knowledge, health beliefs and protective practices.Subjects and Methods: A quasi-experimental design was used. A convenient ample of 120 women were randomly divided into experimental and control groups, each group consisted of 60 women were recruited from outpatient clinic at Obstetrics and Gynecology Department at Minia General Hospital.Results It can be observed that, 86% of the women in the intervention group had good knowledge compared to only 17% of the control group and the difference is statistically significant. The mean score of perceived susceptibility and barriers in both groups was reduced but the decrease was significantly higher in the intervention group (P&lt;0.004). The mean score of perceived severity and benefits in both groups were increased, but the increased mean score in the intervention group was higher. A highly statistical significant difference was observed between groups regarding protective practices (p = .001).Conclusion: It can be concluded that there was a highly statistical significant improvement in women knowledge was observed and the higher positive beliefs about perceived benefits of preventive health practices, susceptibility, severity, health motivation and reduced the barriers of pap smear this can influence women’s willingness to take preventive test and higher participation in regular Pap smear test in the intervention group. The most commonly barriers to screening cited in our study are lack of knowledge.Recommendations: on the light of this findings it is recommended that, women should be encouraged to take responsibility for their own health and be active participants in the screening program, More educational intervention is needed to encourage adherence to routine cancer screening with raising women’s awareness about cervical cancer, The barriers to Pap smear test are considered by the health authorities in order to overcome barriers of cervical cancer screening. Â

Knowledge, attitude, practice and barriers of cervical cancer screening among women living in mid-western rural, Nepal.

ObjectiveTo find out the knowledge, attitude, practice, and barriers of cervical cancer screening in mid-western rural, Nepal.MethodsA hospital-based cross-sectional study was conducted. Women aged 20 or more were interviewed using a structured questionnaire regarding the socio-demographic information, knowledge, attitude, practice, and barriers to the cervical cancer screening.ResultsTotal of 360 participants were recruited for this study, mean age was 30.13±10.4 years. More than 87% of participants had inadequate knowledge, but around 72% had a favorable attitude towards cervical cancer screening. There was a significant portion of women (86.4%) had never done any cervical cancer screening test. Despite being higher literacy rate of Brahmin and Chhetri ethnic group, they were less likely to attend the cervical cancer screening than Dalit and Janajati (p<0.001); and those who had a positive family history of cancer were more likely to attend the cervical cancer screening (p<0.001). Similarly, married women, who had adequate knowledge and or favorable attitude, were more likely to practice cervical cancer screening, though statistically not significant. Factors such as “No symptoms,” “Lack of awareness,” “Embarrassment,” etc. were the most common barriers for the cervical cancer screening.ConclusionThe adequate knowledge and practice of cervical cancer screening were meager among rural Nepalese women, but most of them had a favorable attitude. There is an imperative need for related awareness programs to promote the uptake of cervical cancer screening tests.

PERCEIVED BARRIERS OF CERVICAL CANCER SCREENING AMONG MARRIED WOMEN IN MINGGIR, GODEAN, GAMPING SUB-DISTRICTS, SLEMAN DISTRICT YOGYAKARTA

Abstract Coverage of cervical cancer screening in Indonesia has only reached 5% and cervical cancer in Indonesia is still relatively high. The aimed of this cross-sectional study were to explore perceived barriers of cervical cancer screening and regular screening history among 384 married women in Sleman, Yogyakarta. Data were collected using modified questionnaire items from Champion Health Beliefs Model Scale. Results showed that only 13.8% of respondent have regular screening. Most of respondent in both group Regular and Non-regular/Never had screening perceived that they preferred a female doctor to conduct a screening. Significant association was found between perceived barriers for screening and women’s regular screening history (p-value =0.000). Important barriers reported from this study were male physicians, time-consuming for screening procedure, and embarrassment. Effort to increase screening need to focus on women who have high perceived barriers so that cervical cancer screening’s promotion can be achieved.

Perceived Benefits and Barriers of Cervical Cancer Screening Among Chinese American Women.

To explore the perceived benefits and barriers to cervical cancer screening among Chinese American women using stages of the Transtheoretical Model of Change. . Cross-sectional design with self-report surveys. . Chinese communities (e.g., churches, supermarkets, restaurants) in Northern California and Northern Nevada. . 121 Chinese women aged 21-65 years living in Northern California and Northern Nevada. . A snowball sampling technique using personal contacts was used. . Stages of change and perceived benefits and barriers to cervical cancer screening. . Participants in the action/maintenance stage were most likely to believe that cervical cancer was treatable if caught early. Women in the contemplation/preparation stage were more likely to state that they worried about or feared screening, that it was too expensive, and that they would want to use Chinese medicine to cure an illness before trying Western medicine. Women in the precontemplation/relapse stage were most likely to report that they did not know where to get screened and that their partner would not want them to be screened. . Perceived benefits and barriers to screening were differentially associated with the stages of change. Results may support culturally sensitive and theory-based programs to improve screening rates among Chinese American women. . The results suggest the importance of cultural sensitivity among nursing providers when working with Chinese Americans to provide more relevant, holistic care.

Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women

A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00–2.43), language barriers (OR 4.72, 95% CI 2.62–8.50), and male physicians (OR 2.16, 95% CI 1.32–3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16–3.44) and Blacks (OR 2.06, 95% CI 1.15–3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.

PERCEIVED BARRIERS OF CERVICAL CANCER SCREENING AMONG MARRIED WOMEN IN MINGGIR, GODEAN, GAMPING SUB-DISTRICTS, SLEMAN DISTRICT YOGYAKARTA

Abstract Coverage of cervical cancer screening in Indonesia has only reached 5% and cervical cancer in Indonesia is still relatively high. The aimed of this cross-sectional study were to explore perceived barriers of cervical cancer screening and regular screening history among 384 married women in Sleman, Yogyakarta. Data were collected using modified questionnaire items from Champion Health Beliefs Model Scale. Results showed that only 13.8% of respondent have regular screening. Most of respondent in both group Regular and Non-regular/Never had screening perceived that they preferred a female doctor to conduct a screening. Significant association was found between perceived barriers for screening and women’s regular screening history (p-value =0.000). Important barriers reported from this study were male physicians, time-consuming for screening procedure, and embarrassment. Effort to increase screening need to focus on women who have high perceived barriers so that cervical cancer screening’s promotion can be achieved.

Perspectives from Healthcare Providers and Women about Completing Human Papillomavirus (HPV) Self-Testing at Home

Abstract Purpose: Cervical cancer (CC) incidence and mortality rates are increased and CC screening rates are low among women living in Ohio Appalachia. Mailing human papillomavirus (HPV) self-tests to women to complete at home is a potential new strategy in the United States to engage women in the CC screening process. Our study sought to understand both providers' and women's perspectives on an HPV self-test that could be mailed to women and how those viewpoints may differ and/or concur. Methods: Focus groups were conducted (2014–2015) among: 1) healthcare providers practicing in four Federally Qualified Health Centers (FQHCs) located in three Ohio Appalachia counties; and 2) women living in Ohio Appalachia. Results: Providers (n = 28) and women (n = 15) were accepting of HPV self-testing, however, the reason for acceptance differed between groups. Providers thought HPV self-testing would increase the possibility that under-screened women would return to the healthcare system, while women thought completing HPV self-tests at home would eliminate logistical/psychological CC screening barriers. Facilitators of completing an HPV self-test at home reported by women included decreased embarrassment, and the time and money saved by avoiding a doctor's appointment. Barriers to completing an HPV self-test at home reported by providers and women included women not being aware of the test, concerns about incorrectly completing the test and potential contamination of the obtained specimen, potential discomfort associated with completing the test, safety of the sample when returning it through the mail, issues associated with communicating test results (timing, channel, findings), and needed follow-up care. Both providers and women stressed the importance of including educational information about HPV and cervical cancer and detailed HPV self-test instructions with the mailed device. Conclusions: Findings provide insights into the facilitators and barriers of completing an HPV self-test at home, returning it, reporting results, and providing needed follow-up care. This information will be useful in developing CC screening programs that include mailed HPV self-tests.

Personal and socio-cultural barriers to cervical cancer screening in Iran, patient and provider perceptions: a qualitative study.

Although cervical cancer is preventable and early screening might decrease the associated mortality, challenges faced by the women and health care providers can postpone early detection. This qualitative study aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervical cancer screening in Mashhad, Iran. In the present study, which was conducted in 2012, eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis and Atlas-Ti software. One theme and two categories were derived from data including: cognitive/behavioral factors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lack of health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition, modernity and religious, extra marital relationships and cultural taboos). Providing community based approach education programs and employing social policy are needed for preventing of cervical cancer in Iran.

Abstract A19: Acceptability of the Pap test versus an HPV self-sampler for cervical cancer screening among women of Haitian descent

Abstract Purpose: Cervical cancer screening disparities have been acknowledged in cities with growing Haitian populations. These disparities are attributed to high incidence and low cervical screening rates. There are barriers leading to increased disease incidence and hindering cervical cancer screenings. The purpose of this research is to replicate an evidence-based cervical cancer screening intervention Pap tes Lakay (Haitian Creole for at home Pap test). Implementing this intervention may serve as an effective strategy to help eliminate cervical cancer screening barriers in at-risk communities, including women of Haitian descent in Metro-Atlanta. Pursuit of this research endeavor will also assess cervical cancer screening preference (Self-Sampling for Human papillomavirus versus Papanicolaou test) among program participants. Methods: Pap tes Lakay is a culturally-effective approach to the cervical cancer screening disparity among Haitian women. Through this community-based participatory research (CBPR) intervention, Kobetz et al. disseminated linguistically- and culturally-appropriate cervical cancer prevention education to Haitian women utilizing community health workers (CHWs). CHWs demonstrated proper use of an HPV Self-Sampler, a device that detects abnormal cervical cell growth and other abnormalities. Investigators will replicate this evidence-based cervical cancer screening intervention and recruit and train bilingual Haitian American CHWs. CHWs will solicit participant informed consent, administer baseline surveys, deliver education, demonstrate proper Self-Sampler use, and administer post surveys. Results: A University of Miami study demonstrated high acceptability of an at-home HPV Self-Sampler. Implementation of Pap tes Lakay proved efficacious in increasing cervical cancer screening among Haitian women in South Florida. Previous results indicate 98% would recommend the HPV Self-Sampler to friends and family; 96% felt comfortable using it and 95% thought that it was easy to use. Discussion: The high rates of acceptance indicate that self-sampling may be a viable alternative to increasing cervical cancer prevention among this underserved population. This demonstrates Pap tes Lakay is a culturally-appropriate method to address cervical cancer screening disparities among women of Haitian heritage. Future plans include implementation of this evidence-based intervention in Metro Atlanta and assessing cervical screening preference among women of Haitian descent. Citation Format: Francesca Damus, Selina A. Smith, Ernest Alema-Mensah, Erin N. Kobetz. Acceptability of the Pap test versus an HPV self-sampler for cervical cancer screening among women of Haitian descent. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A19. doi:10.1158/1538-7755.DISP13-A19

Promoters of and barriers to cervical cancer screening in a rural setting in Tanzania

ObjectiveTo investigate promoters and barriers for cervical cancer screening in rural Tanzania. MethodsWe interviewed 300 women of reproductive age living in Kiwangwa village, Tanzania. The odds of attending a free, 2-day screening service were compared with sociodemographic variables, lifestyle factors, and knowledge and attitudes surrounding cervical cancer using multivariable logistic regression. ResultsCompared with women who did not attend the screening service (n=195), women who attended (n=105) were older (OR 4.29; 95% CI, 1.61–11.48, age 40–49years versus 20–29years), listened regularly to the radio (OR 24.76; 95% CI, 11.49–53.33, listened to radio 1–3 times per week versus not at all), had a poorer quality of life (OR 4.91; CI, 1.96–12.32, lowest versus highest score), had faced cost barriers to obtaining health care in the preceding year (OR 2.24; 95% CI, 1.11–4.53, yes versus no), and held a more positive attitude toward cervical cancer screening (OR 4.64; 95% CI, 1.39–15.55, least versus most averse). ConclusionEfforts aimed at improving screening rates in rural Tanzania need to address both structural and individual-level barriers, including knowledge and awareness of cervical cancer prevention, cost barriers to care, and access to health information.

Factors Influencing Cervical Cancer Screening in Women Infected With HIV: A Review of the Literature

The purpose of this article is to review and compare factors that influence cervical cancer screening behavior in HIV-infected women and uninfected women. The research literature revealed that age, ethnicity/race, tobacco use, weight, education, economic issues, and risky behaviors such as substance abuse were factors that influenced cervical cancer screening among all women. HIV viral load and CD4+ T lymphocyte count were serologic factors that affected cervical cancer screening in HIV-infected women. Clinicians can use this information to identify patients at risk for poor Pap test adherence. Future interventions to reduce potential barriers for cervical cancer screening are needed in HIV-infected women.