Cervical Cancer Screening Rates Research Articles

National Trends in Cervical Cancer Screening in Adolescents.

To characterize patterns of cervical cancer screening among adolescents ages 14-20 years before and after the 2009 American College of Obstetrics and Gynecology recommendations. Retrospective cohort study. National Ambulatory Medical Care Survey 2005-2016 data. Female adolescents and young women ages 14-26 years. Multivariable logistic regression models identified independent predictors of unindicated cervical cancer screening at office-based visits among adolescents ages 14-20 years. Cervical cancer screening in women ages 14-20 and 21-26 years in 2 time periods: 2005-2008 and 2009-2016. Between 2005 and 2016, 11,768 office visits were among adolescents ages 14-20 years. Overall, the cervical cancer screening rate for young women ages 14-20 years was 4.0%, which decreased from 4.5% to 0.4% (P = .008) during the study period. Adolescents who received cervical cancer screening during an office visit were older (18-20 years: 24.1% vs 14-17 years: 8.2%; P < .001), had a preventive care visit (preventive care: 79.7% vs other visit types: 20.3%; P < .001), and saw an obstetrician/gynecologist (obstetrician/gynecologist: 74.81% vs other specialties: 25.1%; P < .001). After adjusting for age, year, period, insurance status, region, and provider type, screening for cervical cancer was associated with living in the Southern region of the United States (adjusted odds ratio, 1.88; 95% confidence interval, 1.09-3.25; P = .02) and public insurance (adjusted odds ratio, 0.47, 95% confidence interval, 0.34-0.64; P < .001). Despite recommendations, cervical cancer screening continued to occur in the adolescent population-especially older adolescents-creating unnecessary costs and potential harms. These findings show a slow uptake of guidelines nationally and the need for initiatives that encourage implementation of performance measures for providers, including ongoing provider and patient education.

Impact of COVID-19 on Cervical Cancer Screening Rates Among Women Aged 21-65 Years in a Large Integrated Health Care System - Southern California, January 1-September 30, 2019, and January 1-September 30, 2020.

On March 19, 2020, the governor of California issued a statewide stay-at-home order to contain the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* The order reduced accessibility to and patient attendance at outpatient medical visits,† including preventive services such as cervical cancer screening. In-person clinic visits increased when California reopened essential businesses on June 12, 2020.§ Electronic medical records of approximately 1.5 million women served by Kaiser Permanente Southern California (KPSC), a large integrated health care system, were examined to assess cervical cancer screening rates before, during, and after the stay-at-home order. KPSC policy is to screen women aged 21-29 years every 3 years with cervical cytology alone (Papanicolaou [Pap] test); those aged 30-65 years were screened every 5 years with human papillomavirus (HPV) testing and cytology (cotesting) through July 15, 2020, and after July 15, 2020, with HPV testing alone, consistent with the latest recommendations from U.S. Preventive Services Task Force.¶ Compared with the 2019 baseline, cervical cancer screening rates decreased substantially during the stay-at-home order. Among women aged 21-29 years, cervical cytology screening rates per 100 person-months declined 78%. Among women aged 30-65 years, HPV test screening rates per 100 person-months decreased 82%. After the stay-at-home order was lifted, screening rates returned to near baseline, which might have been aided by aspects of KPSC's integrated, organized screening program (e.g., reminder systems and tracking persons lost to follow-up). As the pandemic continues, groups at higher risk for developing cervical cancers and precancers should be evaluated first. Ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy.

Background:Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa.Methods:A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach (n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear.Results:Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women (n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal (n = 14). Half of the women tested positive for infections (n = 36; 51.4%), and a small proportion (n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population (n = 12; 17.1%).Conclusion:Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.

Health consciousness and cervical cancer screening rates in HPV-unvaccinated girls: comparison from HPV-recommended and HPV-recommendation-suspended program periods

ABSTRACT In Japan, the vast majority of females between 13 and 24 are now unvaccinated for HPV and thus unprotected from HPV-caused cervical cancer. We analyzed the differences among these unvaccinated females regarding their understanding of the HPV vaccine, its role in cervical cancer prevention, and their need for cervical cancer screening – based on whether they refused vaccination when their government’s recommendation for HPV vaccination was still in effect (vaccination-recommended group) – or during the last 7 years, while the government suspension was in effect (recommendation-suspended group). The vaccination-recommended group understood more about the HPV vaccine and the best timing for HPV vaccination than the recommendation-suspended group (p < .0001 and p = .002, respectively). We found that girls in the vaccination-recommended group had more chances to talk with the family about cervical cancer and they were more afraid of acquiring the disease (p < .0001 and p < .0001, respectively). The girls in the recommendation-suspended group tended to feel more inhibited from talking about cervical cancer with friends and acquaintances (p = .0262). The cervical cancer screening rate of the vaccination-recommended group was significantly higher (p = .014).

Abstract PO-205: The impact of DSRIP and practice transformation on cancer screening outcomes for Medicaid, low income, and uninsured patients in Texas

Abstract Background In 2011, Texas received federal approval of the 1115 Healthcare Transformation waiver, which went to support the Texas Delivery System Reform Incentive Payment Program (DSRIP) pool, incentivizing the transformation of service delivery practices to improve quality, health status, patient experience, coordination, and cost-effectiveness. To date, no research has described the impact DSRIP has had on cancer screening outcomes on the Texas Medicaid, low income, and uninsured (MLIU) patient population. Objective To describe the impact of practice transformation at an academic medical center primary care practice towards a value- based care delivery model on breast, cervical, and colorectal cancer screening for its MLIU patient population as a result of 1115 Healthcare Transformation Texas waiver. Study Design Retrospective analysis of electronic health record data from 1/1/2017 through 12/31/2018. Participants MLIU patients who received care at an academic medical center primary care practice during the study time frame and met the criteria for colorectal, cervical, and/or breast cancer screenings. Main Measures The primary outcomes for these analyses were proportions of the patient population who received or did not receive the recommended cancer screenings. Key Results After controlling for relevant confounders, we found significantly improved rates of cervical and colorectal cancer screening among Medicaid, low income, and uninsured patients. Conclusions Practice transformation, specifically integrating primary care, quality, and health information technology, resulted in higher rates of cervical and colorectal cancer screening among a high-risk vulnerable group of patients in one year. Further research should be conducted to determine if the findings are reproducible and if the return on investment equals or surpasses the cost of upfront and sustaining costs of practice transformation. Citation Format: Rebecca Jones, Amelie Ramirez, Ramon Cancino. The impact of DSRIP and practice transformation on cancer screening outcomes for Medicaid, low income, and uninsured patients in Texas [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-205.

Abstract PO-252: Exploratory study of cervical cancer screening among Latinas in a remote agricultural community

Abstract Background: Cancer is the leading cause of death among Latinos. Compared to non- Hispanic Whites, Latinos are more likely to be diagnosed with advanced stages of disease and to experience poorer outcomes and quality of life after a cancer diagnosis. Latino women (Latinas) have among the highest cervical cancer incidence rates. Overall, the cervical cancer incidence rate among US Latinas is about 44% higher than among non-Hispanic Whites. Low rates of screening and poor adherence to recommended follow-up after an abnormal test are thought to contribute to the higher cervical cancer mortality rates among Latinas. The lack of timely cancer screening negates the benefits otherwise afforded by early detection of cancer. Limitations in the research contributes to our lack of understanding of the potential web of factors that likely influences cervical cancer screening in Latinas. Purpose: This study aimed to identify and describe potential modifiable factors in the participants that would explain the lack of cervical cancer screening utilization. Methods: In this exploratory study, we recruited Latinas in Monterey County who received primary care in a local community clinic from January 2014 to December 2018. We conducted 7 in-depth interviews to identify the stages of change, health behaviors, health beliefs, perceptions of cancer risk, and self-efficacy to complete recommended cancer screening. All interviews were conducted in Spanish and were audio-recorded. The transcripts were translated from Spanish to English for analysis. Preliminary Findings: The mean age of participants was 52.0 years (SD, 13.7; range, 29-63 years) and all were of Mexican origin. The predictors of cancer screening were identified through the analysis of the transcripts. The lack of income to see a doctor, lack of insurance, lack of knowledge about cancer prevention and risk, and the absence of primary care utilization in their native country, created barriers to cervical cancer screening. Healthy foodways, positive outlook on life, and attending Women, Infant, and Children (WIC) classes facilitated cancer screening use. Religion and cultural factors expressed as “male machismo”, as well as the use of home remedies, and having family support mediated cancer screening behaviors. Conclusion: This exploratory study informs the direction for future intervention research that ultimately can increase community knowledge of the benefits afforded by cancer early detection and timely treatment. Such interventions may result in an increase in cervical cancer screening rates in Latinas. Citation Format: Meng-Han Tsai, Daramola N. Cabral. Exploratory study of cervical cancer screening among Latinas in a remote agricultural community [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-252.

Cervical Cancer Screening and Human Papillomavirus Vaccination among Korean Sexual Minority Women by Sex of Their Sexual Partners.

Cervical cancer-preventive behaviors in Korean sexual minority women (SMW) are underexplored. We aimed to assess the differences in cervical cancer screening uptake and completion of human papillomavirus (HPV) vaccination among Korean SMW by sex of their sexual partners. This cross-sectional study used data from the 2017 Korean Sexual Minority Women’s Health Study; we included Korean lesbian and bisexual women aged ≥20 years. They were divided into three groups: SMW with more than one male sexual partner (male only/both), SMW with only female sexual partners (female-only), or no sexual partner (no partner). Among the 671 participants, 266 (39.6%), 294 (43.8%), and 111 (16.5%) belonged to the male-only/both, female-only, and no partner groups, respectively. Compared to the male-only/both group, the female-only group was significantly less likely to have undergone cervical cancer screening (Adjusted odds ratio (AOR) = 0.24, 95% confidence interval (CI) = 0.15–0.37) and to have completed HPV vaccinations (AOR = 0.58, 95% CI = 0.37–0.91). In conclusion, Korean SMW with only female sexual partners had lower cervical cancer screening and HPV vaccination completion rates than SMW who had male sexual partners. More extensive efforts are needed to improve cervical cancer-preventive behaviors among Korean SMW.

Perceived reproductive health needs among Muslim women in the southern US

Despite growing rates of Muslims in the United States, we know little about the health of Muslim women in this country. Due to the stigma surrounding sex, sexuality, and the cultural beliefs of this population, there may be unique and unknown challenges regarding access to reproductive health care for Muslims in the US. Purpose: This study aims to examine variables that promote and impede access to reproductive health care for Muslim women in the southern US. Methods: This multi-method study included in-person semi-structured interviews (n=15) and an anonymous online survey (n=76). Findings: Participants generally had low rates of gynecological care and cervical cancer screening. The cultural (e.g. waiting for marriage to receive gynecological care) and contextual aspects (e.g. gender) that increased or restricted access to care in terms of screening, providers and education are discussed. We also identified some misconceptions related to screening and contraception. Conclusions: Influences on reproductive health care experienced by participants in this study have similarities yet are distinct from Muslim populations in other countries as well as other groups of women in the US. This study points to a need for more population-focused education of providers, as well as awareness about reproductive health and health care recommendations and access for Muslim women.

Improving Equitable Access to Cervical Cancer Screening and Management.

Each year, 13,000 women in the United States are diagnosed with cervical cancer and 4,000 die from it. Moreover, 8 million women 21 to 65 years of age haven't had a Pap test in five years. Hispanic women have the highest incidence of cervical cancer and are less likely to be screened or return for care. Migrant women can face additional barriers to cervical cancer screening, including federal prohibitions against their participation in public health insurance exchanges and nonemergency Medicaid. Improving cervical cancer screening rates was identified as a priority in a federally qualified health center when only 40% of eligible women were properly screened in 2016. Forty-five percent of the population the clinic serves is uninsured and 60% are Hispanic. The aim of this quality improvement project was to have 75% of the women 21 to 65 years of age who sought care at this clinic during the 60-day project period receive Pap test eligibility screening, enrollment in a state and federal screening program, and case management. Four rapid plan-do-study-act cycles were used. Tests of change included team engagement, patient engagement, eligibility screening, and case log management. Data were analyzed using run charts to evaluate the impact of interventions on outcomes. The interventions consisted of team meetings, a patient engagement tool, an eligibility screening tool, and case log management. Among the women who completed care at the clinic during the 60-day project period, 80% were uninsured and 86% were Hispanic. A total of 87% of women received effective care, which consisted of same-day Well Woman Health Care Program enrollment and a same-day Pap test or an appointment to return for a well-woman visit. A multicomponent approach led to underserved women receiving equitable access to cervical cancer screening and timely enrollment in a cervical cancer screening program.

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics.

IntroductionPrimary care providers who lack reliable referral relationships with specialists may be less likely than those who do have such relationships to conduct cancer screenings. Community health centers (CHCs), which provide primary care to disadvantaged populations, have historically reported difficulty accessing specialty care for their patients. This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.MethodsUsing a 2017 survey of CHCs in 12 states and the District of Columbia and administrative data, we estimated the association between a composite measure of CHC/specialist integration and 1) colorectal and cervical cancer screening rates, and 2) 4 measures of CHC/specialist communication using multivariate regression models.ResultsIntegration strategies commonly reported by CHCs included having specialists deliver care on-site (80%) and establishing referral agreements with specialists (70%). CHCs that were most integrated with specialists had 5.6 and 6.8 percentage-point higher colorectal and cervical cancer screening rates, respectively, than the least integrated CHCs (P < .05). They also had significantly higher rates of knowing that specialist visits happened (67% vs 42%), knowing visit outcomes (65% vs 42%), receiving information after visits (47% vs 21%), and timely receipt of information (44% vs 27%).ConclusionCHCs use various strategies to integrate primary and specialty care. Efforts to promote CHC/specialist integration may help increase rates of cancer screening.

Age-appropriate cancer screening: A cohort study of adults with psoriasis prescribed biologics, adults in the general population, and adults with hypertension

Psoriasis is associated with increased risk of developing and dying from cancer. To evaluate whether psoriasis patients who are prescribed biologics receive the recommended screening for cervical, breast, and colon cancer. We conducted a retrospective cohort study using the Optum deidentified Electronic Health Record data set. Incidence rates for cervical, breast, and colon cancer screening were compared between psoriasis patients who were prescribed biologics and 2 matched comparator cohorts: general patient population and patients being managed for hypertension. Multivariable Cox proportional hazards regression was performed to assess for differences in the rates of cancer screening. Compared with those in the general population without psoriasis, psoriasis patients who were prescribed biologics had higher screening rates for cervical cancer (adjusted hazard ratio [aHR] 1.09; 95% confidence interval [CI] 1.02-1.16) and colon cancer (aHR 1.10; 95% CI 1.02-1.18). Compared with those with hypertension, patients with psoriasis who were prescribed biologics had lower screening rates for breast cancer (aHR 0.88; 95% CI 0.83-0.94) and colon cancer (aHR 0.89; 95% CI 0.83-0.95). Patients with psoriasis who are prescribed biologic therapies may not be receiving adequate age-appropriate cancer screening, especially for breast and colon cancer.

Cancer Screening During the Coronavirus Disease-2019 Pandemic: A Perspective From the National Cancer Institute’s PROSPR Consortium

Cancer Screening During the Coronavirus Disease-2019 Pandemic: A Perspective From the National Cancer Institute’s PROSPR Consortium

High and Sustained Participation in a Multi-year Voluntary Performance Measurement Initiative Among Primary Care Teams.

Background: The province of Ontario, Canada has made major investments in interdisciplinary primary care teams. There is interest in both demonstrating and improving the quality of care they provide. Challenges include lack of consensus on the definition of quality and evidence that the process of measuring quality can be counter-productive to actually achieving it. This study describes how primary care teams in Ontario voluntarily measured quality at the team level. Methods: Data for this 4-year observational study came from electronic medical records (EMRs), patient surveys and administrative reports. Descriptive statistics were calculated for individual measures (eg, access, preventive interventions) and composite indicators of quality and healthcare system costs. Repeated measures identified patient and practice characteristics related to quality and cost outcomes. Results: Teams participated in an average of 5 of 8 possible iterations of the reporting process. There was variation between teams. For example, cervical cancer screening rates ranged from 21 to 86% of eligible patients. Rural teams had significantly better performance on some indicators (eg, continuity) and worse on others (eg, cancer screening). There were some statistical but small changes in performance over time. Conclusion: High, sustained voluntary participation suggests that the initiative served a need for the primary care teams involved. The absence of robust data standards suggests that these standards were not crucial to achieve participation. The constant level of performance might mean that measurement has not yet led to improvement or that measures used might not accurately reflect improvement. The data reinforce the need to consider differences between rural and urban settings. They also suggest that further analysis is needed to identify characteristics that teams can change to improve the quality of care their patients experience. The study describes a practical, sustainable real-world approach to performance measurement in primary care that was attractive to interdisciplinary teams.

S3199 Cervical Cancer Screening and HPV Vaccine Awareness in Patients With IBD

INTRODUCTION: Studies have shown that patients with inflammatory bowel disease (IBD) have an increased risk of malignancy compared to the general population. In addition, cervical cancer screening in this high-risk group is often suboptimal. Human papillomavirus (HPV) vaccine is recommended, effective, and safe for all patients with IBD. This vaccine not only protects against cervical dysplasia in females, but it could also be effective in reducing the risk of anal, penile, and oral cancers in both genders. The aims of this study are to identify the rate of cervical cancer screening among patients with inflammatory bowel disease and to assess patients’ opinion regarding the HPV vaccine in addition to other vaccines currently recommended. METHODS: A self-designed anonymous survey was conducted on all adult (18–65) patients with IBD who presented for a routine clinic visit. The survey comprised of questions regarding gender, age, diagnosis, current IBD treatment, cervical smear test frequency, and vaccinations currently recommended for patients with IBD. Patients completed the survey in clinic under a physician’s supervision. RESULTS: Survey data from 18 IBD patients (mean age: 36 years, average IBD duration: 13 years) were analyzed. 50% of our patients were females and all of them were on immunomodulators or biologic therapy for IBD. Among surveyed women, 33% reported irregular cervical cancer screening and 33% did not remember when their previous testing was. Only 33% of women undergo testing regularly; 67% annually and 33% every 2 to 3 years. 55% of our patient population reported knowledge of HPV vaccine recommendation for IBD patients. CONCLUSION: Our study documents low awareness of HPV vaccine and suboptimal cervical testing in this outpatient population of IBD patients. A multidisciplinary approach to educate IBD patients about HPV vaccine and cervical testing recommendations is required to improve patients’ adherence and outcomes.Figure 1

Cervical Cancer Screening Rate and Willingness among Female Migrants in Shenzhen, China: Three-Year Changes in Citywide Surveys.

PurposeThis study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city.Materials and MethodsTwo citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years.ResultsIn total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened.ConclusionIdentifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.

Improving uptake of cervical cancer screening services for women living with HIV and attending chronic care services in rural Malawi

Malawi has the second highest age-standardised incidence rate and the highest mortality rate of cervical cancer in the world. Though the prevalence of HIV is currently 11.7% for Malawian women...

Access and use of sexual and reproductive health services among resettled refugee and refugee-claimant women in high-income countries: a scoping review protocol.

The purpose of this review is to understand access to and use of sexual and reproductive health services among resettled refugees and refugee-claimant women in high-income countries. Sexual and reproductive health is a critical component of women's well-being and quality of life. Refugee and refugee-claimant women have demonstrated a lower level of sexual health knowledge and reduced usage of sexual and reproductive health services after resettling in high-income countries. This has led to negative outcomes among resettled refugee populations, including unwanted pregnancies and abortion, lower than recommended rates of cervical cancer screening, high rates of sexually transmitted infections, and non-consensual sex. Despite these negative outcomes, no review has been conducted to understand access to and use of sexual and reproductive health services among resettled refugee women in high-income countries. This scoping review will seek to identify studies that describe access to and use of sexual and reproductive health services among refugee and refugee-claimant women who have resettled in a high-income country. Evidence from qualitative, quantitative, mixed method studies, and gray literature will be included. This review will be conducted in accordance with JBI methodology for scoping reviews. A comprehensive search strategy, developed with a librarian scientist, will be used to identify relevant sources. Titles, abstracts, and full texts will be evaluated against inclusion criteria. Information will be extracted by two independent reviewers using a screening tool. Data will be synthesized and presented narratively, with tables and figures where appropriate.

Differences in Breast and Cervical Cancer Screening Among U.S. Women by Nativity and Family History

System-level factors such as poor access to health services can help explain differential uptake in breast and cervical cancer screening between U.S.- and foreign-born women. However, few studies have explored the roles of family history and perceived risk of these cancers on screening rates. To address these gaps, this study investigates whether a family history of cancer, perceived risk, and system-level factors independently and additively predict differential screening rates of breast and cervical cancer between U.S.-born and foreign-born women living in the U.S. Data were analyzed in 2019 from the 2015 National Health Interview Survey. Descriptive and multivariable logistic regression modeling was performed to test whether there were differences in breast and cervical cancer screening within and between the 2 groups and whether family history of cancer and perceived risk of breast cancer were predictors of uptake. The sample comprised women aged 21-74 years (n=14,047). The mean age of the sample was 45.5 (SD=14.8 years). The majority of the women were U.S.-born (77.5%). U.S.- and foreign-born women had more mammograms and Pap tests with a usual source of care (p<0.001) and insurance (p<0.001). Healthcare access and utilization factors were also predictive for both groups of women. Data analyses were conducted in 2019. These findings are consistent with previous work. Access and healthcare utilization were associated with screening uptake. However, differences in risk perception, family history of breast and cervical cancers, and screening uptake were found between U.S.- and foreign-born women.

Biopsychosocial risk factors and knowledge of cervical cancer among young women: A case study from Kenya to inform HPV prevention in Sub-Saharan Africa.

Cervical cancer is the second most common female reproductive cancer after breast cancer with 84% of the cases in developing countries. A high uptake of human papilloma virus (HPV) vaccination and screening, and early diagnosis leads to a reduction of incidence and mortality rates. Yet uptake of screening is low in Sub-Saharan Africa and there is an increasing number of women presenting for treatment with advanced disease. Nine women in their twenties die from cervical cancer in Kenya every day. This paper presents the biopsychosocial risk factors that impact on cervical cancer knowledge among Kenyan women aged 15 to 24 years. The findings will highlight opportunities for early interventions to prevent the worrying prediction of an exponential increase by 50% of cervical cancer incidences in the younger age group by 2034. Data from the 2014 Kenya Demographic and Health Survey (KDHS) was analysed using complex sample logistic regression to assess biopsychosocial risk factors of knowledge of cervical cancer among young women aged 15 to 24 years (n = 5398). Close to one third of the participants were unaware of cervical cancer with no difference between participants aged 15-19 years (n = 2716) and those aged 20-24 years (n = 2691) (OR = 1; CI = 0.69-1.45). Social predisposing factors, such as lack of education; poverty; living further from a health facility; or never having taken a human immunodeficiency virus (HIV) test, were significantly associated with lack of awareness of cervical cancer (p<0.001). Young women who did not know where to obtain condoms had an OR of 2.12 (CI 1.72-2.61) for being unaware of cervical cancer. Psychological risk factors, such as low self-efficacy about seeking medical help, and an inability to refuse unsafe sex with husband or partner, perpetuated the low level of awareness about cervical cancer (p<0.001). A considerable proportion of young women in Kenya are unaware of cervical cancer which is associated with a variety of social and psychological factors. We argue that the high prevalence of cervical cancer and poor screening rates will continue to prevail among older women if issues that affect young women's awareness of cervical cancer are not addressed. Given that the Kenyan youth are exposed to HPV due to early sexual encounters and a high prevalence of HIV, targeted interventions are urgently needed to increase the uptake of HPV vaccination and screening.

A Systematic Review of Intervention on Improving Cervical Cancer Screening Rates

Cervical cancer is a disease that can be prevented through early detection. However, cervical cancer is the fourth leading cause of death for women globally due to the low coverage of cervical cancer screening. An intervention is needed to increase the coverage of cervical cancer screening. This study aimed to provide current evidence of effective interventions to improve cervical cancer screening coverage, especially with low socio-economic conditions. This study uses a systematic design review to review the literature that has been evaluated in a structured, classified, and categorized based on evidence-based previously. The study's inclusion characteristics are as follows: all article searches are limited to those in English or Indonesian only, and scan bibliography to identify relevant articles, method design is RCT studies, or quasi-experiments. The study results found the characteristics of the article as follows: the majority of studies were conducted in the Americas, two studies in Asia, and one in Europe. The respondents' age varied from&gt; 18 years to 75 years; the number of samples ranged from 102 to 12,061 respondents. Interventions were grouped into three types, namely: health education, self-testing, and reminders of the screening schedule. Among the three types of interventions most recommended is counseling with video media, because providing information with exciting media will increase knowledge which will increase women's interest in screening. Independent screening interventions can also increase the coverage of cervical cancer screening in women with low socio-economic conditions because this method allows more savings in funding