High Rates Of Cervical Cancer Research Articles

Increasing cervical cancer screening in Iran: effectiveness of a theory-based educational intervention

Purpose of studyThe high mortality rate of cervical cancer in developing countries is mainly related to inefficient screening programs. The aim of the present study was, thus, to determine the effect of an educational intervention based on BASNEF (Belief, Attitudes, Subjective Norms, and Enabling Factors) model on increasing the rate of cervical cancer screening (CCS) in Bandar Deir in the south of Iran.MethodsA quasi-experimental educational intervention was made with 202 women participants (101 in the intervention group (IG) and 101 in the control group (CG)) in 2019–20. The sampling was convenience in type. The data were collected using a reliable and valid tripartite questionnaire (demographic information, knowledge, BASNEF constructs). A total number of 14 training sessions were held each taking 60 min, at two levels, personal and interpersonal (for family members, health workers and healthcare givers). Finally, there was a three-month follow-up held in December 2021.ResultsAfter the training, a statistically significant difference was found between the IG and CG in all model constructs (p < 0.001). Before the intervention, in the IG, the personal health score was 4.35 ± 2.52, which was increased to 5.25 ± 0.753 after the training (p < 0.001). However, in the CG, the difference was not statistically significant (p < 0.030). 63.4% of women in the IG and 32.7% in the CG performed the CCS and the between-group difference was statistically significant (p < 0.001). Attitude, enabling factors and behavioral intention were the main predictors of CCS.ConclusionThe present findings showed though the training intervention based on the BASNEF model had limited resources and was run in a short time, it managed to motivate women to perform the CCS. It could maximally remove barriers at both personal and interpersonal levels and suggest strategies in the light of these barriers to achieve a successful screening program.

Human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review protocol

IntroductionEvidence shows that women in sub-Saharan Africa have high rates of cervical cancer (CC) mortality compared with women in high-income countries. Effective screening programmes have significantly reduced the burden of...

"We Shall Tell them with Love, Inform them what we have Learnt and then Allow them to go"- Men's Perspectives of Self-Collected Cervical Cancer Screening in Rural Uganda: A Qualitative Inquiry.

Uganda has high incidence rates of cervical cancer (47.5/100,000/year) due to limited screening access. In settings where men hold most of the decision-making power, they play an important role in women's uptake of cervical cancer screening. We aimed to capture men's knowledge, beliefs and perspectives about cervical cancer, community-based screening and health system barriers. Focus group discussions were conducted with men in rural Uganda. Data were verbatim translated and transcribed into English. Transcripts were analysed in ATLAS.ti using a deductive approach of thematic content analysis and applied to an implementation research framework. Twenty-three men participated in focus groups. Men held poor knowledge of cervical cancer, its causes and treatment. Men felt screening would be acceptable by women if men and women were educated. Men highlighted health system barriers to accessing screening including: 1) poor-quality health services, 2) large distances to facilities/lack of affordable transportation and 3) lack of health workers/mistreatment by health workers. Men described supporting women through assisting with transportation, psychosocial support and sharing information. They requested services for men to be decentralized alongside community outreaches for cervical cancer screening. Engaging men in the implementation, education and planning of community-based cervical cancer screening programs is critical. Not engaging men is a missed opportunity to provide them with services and education. Concerted efforts must be made in educating men and reducing health system barriers to ensure rural women receive cervical cancer screening and follow-up care in low-income settings. Clinicaltrials.gov, NCT04000503; Registered 27 June 2019.

Assessment of ESGO Quality Indicators in Cervical Cancer Surgery: A Real-World Study in a High-Volume Chinese Hospital.

The ESGO developed a list of fifteen quality indicators for cervical cancer surgery in order to audit and improve clinical practice in 2020. However, data from the developing countries with high incidence rates of cervical cancer is still lacking. Therefore, we conducted a retrospective study of 7081 cases diagnosed as cervical cancer between 2014 and 2019 in a Chinese single center according to the quality indicators proposed by ESGO. A total of 5952 patients underwent radical procedures, with an average of 992.0 per year. All surgeries were performed or supervised by a certified gynecologic oncologist as surgical qualification grading system has been established. Compared with the low-volume group, patients in the high-volume group (≥15 cases/year) had a shorter hospital stay (P<0.001), more free surgical margins (P=0.031), and less complications (P<0.001), but the 5-year recurrence-free survival and overall survival rates were similar (P>0.05). Treatment was not planned at a multidisciplinary team meeting but with the consultation system. The required preoperative workup was incomplete in 19.7% of patients with pelvic MRI and 45.7% of patients with PET-CT. A total of 1459 (20.6%) patients experienced at least one complication after surgery. The CDC grade IIIb or higher complications occurred in 80 patients, accounting for 5.5% complications. The urological fistula rate within 30 postoperative days were 0.3%. After primary surgical treatment, 97.4% patients had clear vaginal and parametrial margins. After restaging FIGO 2009 to FIGO 2018 system, 14.7% patients with a stage T1b disease were T-upstaged. After a median follow-up of 42 months, recurrence occurred in 448 patients, and 82.1% patients recurred within 2 years. The 2-year RFS rate of patients with pT1b1N0 was 97.3% in 2009 FIGO staging system. Lymph node staging was performed in 99.0% patients with a stage T1 disease. After a primary surgical treatment for a stage pT1b1N0 disease, 28.3% patients received adjuvant chemoradiotherapy. Above all, most of quality indicators reached the targets, except four quality indicators. The quality indicators of ESGO should be popularized and applied in China to guarantee quality of surgery.

The State of Cervical Cancer Screening and HPV Vaccination in Africa: In the Advent of Advanced Health Care

Cervical cancer if not detected and treated promptly can be lethal to females. In several advanced nations, the relevance of coordinated screening services has been implemented. Nevertheless, most developing nations have not implemented a nationwide screening and vaccination programme accessible to all women owing to inadequate screening and vaccination services coupled with vaccine scepticism, misconception concerning vaccination, and lack of awareness are causing an upsurge in Africa's cervical cancer cases. Cervical cancer could be greatly reduced if comprehensive screening services and HPV vaccination are implemented. In this review, we discussed the cervical cancer incidence in Africa, factors influencing the high rate of cervical cancer in Africa, screening and HPV vaccination programs and the potential intervention and recommendations to reduce the incident and mortality rates of cervical cancer in Africa. Also, we highlighted the disadvantages and advantages of widely accessible screening tests in Africa.

Improving preventive screening with Indigenous peoples.

> Aboriginal women, for example, have expressed concern that epidemiological risk profiles for cervical cancer used in public health campaigns could further stigmatize aboriginal women as lascivious and irresponsible. Instead, analyses are needed that recognize that high rate of cervical cancer (

Communication Among Southeast Asian Mothers and Daughters About Cervical Cancer Prevention.

Southeast Asian women have high rates of cervical cancer and yet are among the least likely to be screened. There is sparse literature on communication patterns among Southeast Asian women, specifically related to cervical cancer and Pap test uptake. Little is known about the influence of Southeast Asian mothers and daughters on each other's cervical cancer beliefs and screening behaviors. We examined the perceptions of and barriers to cervical cancer screening among Cambodian and Lao mothers and daughters and explored how they converse about women's health issues, specifically cervical cancer and Pap testing. We conducted in-depth interviews with Cambodian and Lao mother-daughter dyads, aged 18 years and older, living in a large Midwestern city between February and September of 2015. Descriptive statistics were calculated to summarize the sample demographic characteristics. Bivariate tests (contingency table analyses, independent t-tests, and Pearson correlations) were conducted to test for differences between the mothers and daughters in demographic characteristics and measures of health status and beliefs. Qualitative data were analyzed using content analysis. In-depth interviews were conducted with three Cambodian and eight Lao mother-daughter dyads. The daughters were significantly more acculturated to English, had greater education, and were mostly employed full time. The mothers and daughters evaluated their health status much the same, their medical mistrust equally, and all of the mothers and nine of the daughters were Buddhist. Themes in mother-daughter communication included what mothers and daughters do and do not talk about with regard to sexual health, refugee experiences, what hinders mother-daughter communication, and relationship dynamics. The mothers were embarrassed and uncomfortable discussing cervical cancer, Pap testing, and other women's health issues with their daughters. Although mothers did not influence women's health promotion or cervical cancer prevention with their daughters, daughters did influence their mothers' health and healthcare decisions. Daughters were critical in navigating healthcare systems, engaging with providers, and making medical decisions on behalf of their mothers. By leveraging the unique and dynamic intergenerational bond that mothers and daughters who identify as Southeast Asian have, we can develop strategies to influence the cultural dialogue related to cervical cancer and early detection.

The College of American Pathologists Foundation's See, Test & Treat Program®: an Evaluation of a One-Day Cancer Screening Program Implemented in Mississippi.

Women in Mississippi experience significant barriers to healthcare that results in high incidence rates of late-stage breast, cervical, and oropharyngeal cancer. We implemented See, Test, & Treat, a cancer screening and education program, that was aimed at increasing access to cancer screening for underserved women in the Jackson Metropolitan Area. During the event, 103 women between the ages of 21 and 69years old received breast, cervical, and/or oral cancer screenings. Quantitative and qualitative data were collected to evaluate the effect of the program on the participants' cancer screening knowledge, self-efficacy to obtain medical check-ups, and intentions to engage in health-enhancing behaviors. Of the 57 women who received a mammogram, 18 had abnormal results that required follow-up care. None of the women who received a Pap test had abnormal results, but 8 women were diagnosed with trichomoniasis. One woman was diagnosed with stage 4 oral cancer. The evaluation data indicated that participants found that free cancer screenings and receipt of results on the same day were primary benefits of the program.

Addressing high cervical cancer rates in the Rio Grande Valley along the Texas-Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring.

Cervical cancer incidence and mortality rates are approximately 55% higher in the Rio Grande Valley (RGV) along the Texas-Mexico border compared with the average rates in the US. Our aim was to improve cervical cancer prevention efforts in the RGV through a comprehensive multilevel intervention initiative focused on community education, patient navigation, and training of local providers. We initiated a program in the RGV which consisted of (1) community education, (2) patient navigation, and (3) a training/mentoring program for local medical providers including hands-on training courses coupled with telementoring using Project ECHO® (Extension for Community Health Outcomes). We assessed the number of women undergoing cervical cancer screening, diagnosis, and treatment at three participating clinics caring for underserved women in the region. From November 2014 to October 2018, 14,846 women underwent cervical cancer screening. A total of 2030 (13.7%) women underwent colposcopy for abnormal results (179% increase over baseline) and 453 women underwent loop electrosurgical excision procedures (LEEPs) for treatment of cervical dysplasia. Invasive cancer was diagnosed in 39 women who were navigated to a gynecologic oncologist for treatment. Seven local medical providers were trained to perform colposcopy and/or LEEP. Project ECHO telementoring videoconferences were held every 2 weeks for a total 101 sessions with an average of 22 participants per session and a total of 180 patient cases presented and discussed. Our program led to a large number of women undergoing diagnosis and treatment of cervical dysplasia in the RGV. If sustained, we anticipate these efforts will decrease cervical cancer rates in the region. The program is currently being expanded to additional underserved areas of Texas and globally to low- and middle-income countries.

Communicating Healthcare Provider Perspectives about Mi'kmaq Women's Access to Pap Smear Screening in Eastern Canada: A Qualitative Study

Indigenous women have higher rates of cervical cancer and lower rates of Papanicolaou (Pap) smear screening than non-Indigenous in Canada. Healthcare providers are well positioned to address the inequities in access to Pap screening that many Indigenous women continue to experience. The purpose of this study was to explore healthcare providers' experiences and perspectives about Mi'kmaq women's access to Pap smear screening in Eastern Canada, and to consider the broader historical, economic, and sociopolitical contexts that shape healthcare experiences. The methodology is a qualitative, community-based participatory action research approach that embodied Indigenous approaches to knowledge development and post-colonial theoretical perspectives in a two-eyed seeing approach. In-depth semi-structured in-person interviews were conducted with five healthcare providers twice, in two First Nations communities in Nova Scotia. Findings revealed two major overarching themes: a) Understanding the Realities of Indigenous Women's Lives; which involved recognition of the impact of history, and socioeconomic and political factors; and b) Fostering Indigenous Women's Access to Pap Smear Screening, through fostering trusting relationships, cultural safety, addressing confidentiality issues and optimizing processes to improve experiences. Conclusions indicated approaches to foster Mi'kmaq women's access to Pap screening included a social women's day, targeting youth, explaining step-by-step during screening, providing Pap results to women and having nurse practitioners perform screening. Implications for practice comprised addressing confidentiality issues in community health centres, involving the community in Pap screening decision-making, acknowledging the impact of historical trauma on access to screening and optimizing processes to address and improve inequitable access to screening. This study highlights the importance of healthcare providers' participation in understanding and encouraging Indigenous women's access to Pap smear screening. Healthcare providers need to consider a wider view of the realities of Canadian Indigenous women's lives, and acknowledge the impact of historical trauma, socioeconomic factors, and racism on women's accessing of Pap smear screening. Healthcare providers can implement collaborative and culturally safe screening approaches, while acknowledging Indigenous community strengths to improve inequities in healthcare access and health outcomes.

Cervical cancer in women of the Republic of Buryatia (morbidity and mortality compared in subjects of the Siberian Federal District and in Russia as a whole)

Analysis of the morbidity and mortality dynamics of the female population of cervical cancer (CC) of the Siberian Federal District (SFO) as a whole, as well as by its individual subjects for 18 years, from 2000 to 2017. It showed a steady increase in the incidence of this form of cancer (an increase of 37.3%) and a decrease in mortality (a decrease of 11.7%) in the region as a whole and in all its subjects in comparison with those in the Russian Federation (RF). The steadily high incidence rate of cervical cancer during the period analyzed was recorded in Buryatia - 23.1 ± 1.9, after the Trans-Baikal Territory - 29.6 ± 1.7; and the Republic of Tyva - 27.7 ± 2.3; in the neighboring Irkutsk region - 19.3 ± 0.7 cases per standardized 100 thousand population, the lowest - in Kemerovo - 12.8 ± 0.5 and Novosibirsk region - 12.2 ± 0.3 regions. The consistently high incidence rate of cervical cancer during the analyzed period was recorded in the Trans-Baikal Territory - 29.6 ± 1.7; in the Republics of Tyva - 27.7 ± 2.3 and Buryatia - 23.1 ± 1.9, in the Irkutsk region - 19.3 ± 0.7 cases per standardized 100 thousand people, the lowest - in Kemerovo - 12.8 ± 0.5 and Novosibirsk - 12.2 ± 0.3 regions.The Siberian Federal District leads among other regions of Russia in the incidence of cervical cancer in women (especially in Transbaikalia, Tuva, Buryatia and Irkutsk): from 2000 to 2017, theincidence in the region increased 1.4 times with a forecast of further growth, while mortality rates indicate a positive trend - stabilization of the process. In these territories, the carcinogenic situation is determined by the interaction of a complex of various subsystems comprising it: natural, industrial, and social.&#x0D; Key words: cervical cancer; incidence rate; Siberian Federal District.&#x0D;

Papanicolau e a saúde da mulher: importância do fomento à prevenção do câncer de colo uterino

O câncer cervical é uma neoplasia maligna que ocupa um lugar de destaque, chamando a atenção da comunidade científica, das autoridades médicas e governamentais de vários países, dentre eles, o Brasil. Dada as altas taxas de prevalência do câncer de colo uterino, a realização periódica do Papanicolau é considerada a melhor estratégia para a sua prevenção. O objetivo deste estudo é relatar a vivência de discentes do curso de enfermagem decorrida em uma unidade de Estratégia Saúde da Família da cidade de Belém, Pará, ocorrida através da efetuação de uma atividade de educação em saúde sobre o exame Papanicolau. Trata-se de um estudo descritivo com abordagem qualitativa, do tipo relato de experiência, onde a metodologia adotada perpassou pela Teoria da Problematização através da utilização do Arco de Maguerez. Evidenciou-se que algumas das mulheres participantes desconheciam o exame, outras já sabiam de sua existência, mas ainda não entendiam a importância de sua realização. Dentre as participantes, poucas já haviam realizado o exame, sendo que ainda apresentavam algumas dúvidas sobre ele. Acredita-se que que o objetivo da ação foi alcançado, uma vez que as mulheres que participaram destas atividades foram sensibilizadas quanto a relevância da realização do exame, bem como acerca da autonomia em saúde e da importância de um autocuidado diligente e eficaz para a manutenção da saúde e qualidade de vida.

Awareness of and Support for HPV Vaccination Among Pacific Islander Women in Southern California.

Pacific Islander (PI) women experience disproportionately high rates of cervical cancer and mortality and have lower rates of Pap testing. Since up to 70% of cervical cancers could be prevented by being vaccinated for human papilloma virus (HPV), this cross-sectional study explored the predictors of HPV and vaccine awareness, receipt of the vaccine, and attitudes toward vaccinating children among adult PI women in southern California, who historically have low rates of HPV vaccination and high rates of cervical cancer that could be prevented with HPV vaccination. Participants (n=148) consist a subsample of Chamorro, Samoan, and Tongan women, ages 21 to 65 years, who were in a larger randomized community study to promote Pap testing. Overall, younger age and higher American acculturation were significantly associated with ever hearing about HPV and the vaccine. However, American acculturation was also associated with negative attitudes toward vaccinating their children for HPV. This paper provides preliminary insights into barriers and facilitators to HPV vaccination among PIs in the USA and also informs the development of educational programs to reduce cervical cancer incidence and mortality in this underserved population.

The Importance of Post Coital Bleeding in Countries with Low Level Cervical Cancer Screening

Background & Objective: This study aimed to examine the extent to which postcoital bleeding (PCB) can be a predictive factor for cervical cancer. Materials & Methods: In this observational study we selected and evaluated 280 females with PCB referred to Kowsar Hospital of Qazvin, Iran from 2017 to 2019. Results: Among the 189 patients diagnosed as normal in their Pap smear results, one patient had cancer in her biopsy results. A closer look at the biopsy results of the patients showed 45 patients as normal, 64 patients with cervical infection, 31 patients with polyp cervix, 45 patients with cervical intraepithelial neoplasia 1 (CIN 1), and one patients with squamous cell carcinoma (SCC). Among 63 patients diagnosed with atypical squamous cells of undetermined significance (ASCUS), three showed CIN 2 and CIN 3 in their biopsies. Furthermore, out of 21 patients with low-grade squamous intraepithelial lesion (LSIL), three patients had CIN 2 and CIN 3, one patient had carcinoma, and one had SCC. In addition, all of the patients with highgrade squamous intraepithelial lesion (HGSIL) were diagnosed with CIN 2, CIN 3, and SCC. Conclusion: Because of the higher rate of cervical cancer in women with PCB and inconsistent screening programs in developing countries, it is essential to carefully consider the symptoms of PCB despite having a normal Pap smear.

A Enfermagem frente ao câncer do colo de útero

Devidos às taxas elevadas de prevalência e mortalidade do câncer cérvicouterino, é imprescindível que seja adotada de forma efetiva, estratégias para a adesão do rastreamento da doença através do exame Papanicolau, sendo o enfermeiro de suma importância neste processo de prevenção e promoção de saúde, trazendo uma assistência integralizada e humanizada durante a realização do exame citopatológico. Esse artigo tem por premissa, promover uma revisão integrativa-qualitativa, sendo estabelecidas as coletas de dados da seguinte forma: seleção da base de dados, filtragem dos textos, critérios de inclusão e exclusão, categorização dos estudos e avaliação dos trabalhos selecionados, tendo por objetivo: Analisar os fatores que impedem a adesão aos programas de prevenção e rastreamento, bem como identificar as abordagens dos profissionais que vêm sendo formados para atuar nesse contexto. O estudo demonstrou desinformação por parte das mulheres, desconforto, medo do exame preventivo e o despreparo da equipe em acolher, orientar e atender estas de forma humanizada. Assim, sugere-se a elaboração de outros estudos a respeito do tema, que identifique as estratégias e esforços que estão sendo reunidos para que as taxas de incidência diminuam, e ainda, que as instituições responsáveis por formar profissionais de Enfermagem, reforcem as disciplinas que abordem o tema em questão.

Trends in referral and management of abnormal Pap tests by race at an academic colposcopy clinic

Objective: This study examined management of abnormal Pap tests by race among women referred to an academic colposcopy clinic, given that minority women have higher rates of cervical cancer and poorer outcomes.

Awareness of Cervical Cancer and Attitude Toward Human Papillomavirus and Its Vaccine Among Ghanaians.

Background: Cervical cancer (CC) is the fourth most commonly diagnosed cancer among women. Ghana is a low-middle- income country with annual diagnosed cases of 3,151 and 2,119 deaths. The high prevalence rate of cervical cancer in Ghana is mainly due to ineffective preventive measures and insufficient knowledge about the disease. Therefore, our objective was to evaluate the level of knowledge and awareness of cervical cancer and attitude toward human papillomavirus and its vaccine among Ghanaians.Methods: This descriptive cross-sectional survey on the awareness of cervical cancer and attitude toward human papillomavirus and its vaccine was carried out from March 2019 to February 2020. SPSS v. 23.0 was used in the data analysis. The participants' demographic characteristics, knowledge of cervical carcinoma, human papillomavirus vaccine and HPV, and the likelihood to be vaccinated were represented as percentages and frequencies. The difference between males and females was assessed using the chi-square test. The logistic regression analysis was used to evaluate the relationship of possible related indicators with the willingness to receive the HPV vaccine. A p < 0.05 was considered statistically significant.Results: A total of 1,376 participants were involved in the final analysis. Among the 1,376 participants involved in this survey, 1,240 participants (90.1%) representing 456 males (33.1%) and 784 females (57.0%) were aware of the terminology “cervical cancer” with a significant p = 0.001. When stratified by gender, women had significantly greater knowledge, compared to men in terms of “cervical cancer being common in middle age (35–50) females” (75.5 vs. 67.5%, respectively, p ≤ 0.001). When stratified by gender, women had significantly greater knowledge of human papillomavirus (54.5 vs. 43.6%, respectively, p < 0.001) and the human papillomavirus vaccine (39.3 vs. 33.1%, respectively, p = 0.019) compared to men.Conclusion: Majority of the respondents had poor knowledge regarding cervical cancer risk factors, symptoms, HPV, and its vaccine. Hence, this indicates a wakeup call for government to increase the awareness and knowledge level via the media and health professionals.

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 C023: Cervical cancer survival analysis based on screening practices and the socioeconomic position index in Puerto Rico

Abstract Background: Cervical cancer ranks as the 7th most diagnosed cancer among women in Puerto Rico (PR). When compared to all the states and territories of the United States of America (USA), PR has the highest rate of cervical cancer. Cervical cancer is preventable through screening. While the Healthy People’s 2020 goal is a screening rate of 93%, PR falls short at 77%. There is extensive research on how women with screen-detected cancers have better survival than those whose cancer is detected symptomatically. Cancer stage is the primary prognostic factor affecting survival. Yet, stage at diagnosis is a complex interaction among many factors, including social and economic inequities. Evaluating how socioeconomic status and screening behavior affect survival will provide insight into how disparities affect health outcomes. Objective: The purpose of this study is to evaluate the effect of screening behavior and socioeconomic position on the survivorship of cervical cancer patients diagnosed in PR during the period of 2011-2014. Methods: The Puerto Rico Central Cancer Registry (PRCCR) was used to identify all incident cases of primary cervical cancer in women 21 years of age or older, determine the occurrence of the event of interest, and obtain study variables. The database acquired through the PRCCR was linked with health insurance data claims. Through this linkage, cervical cancer screening behavior was documented for at least 3 years before patients’ diagnosis. From 937 patients with primary cervical cancer diagnosed during this period, 44% (n=408) were included for this analysis as they had complete information on insurance coverage during the past 3 years (continuous enrollment) and had a microscopically confirmed diagnosis. These patients were followed up to 2017 in order to measure 3-year survival. The Kaplan-Meier Method was used to describe 3-year survival. Also, the Cox Model was used to estimate the risk of death from cervical cancer depending on screening behavior, while controlling for potential confounders. Results: Over half of the patients (52.7%) were insured by Medicaid, 41.2% resided in the area of lowest socioeconomic position (SEP), and only 72.1% were screened 3 years before their diagnosis. Although there weren’t any observable differences in survival curves by SEP, 3-year survival was 77% (95% CI 71.3-81.0) among screened patients and 60% (95% CI 50.1-84.6) among unscreened patients. The overall 25th percentile survival time was about 31 months. The 25th percentile survival time was higher for screened patients (42 months) when compared to unscreened patients (14 months). After controlling for age, stage, histology, and tumor stage, screened patients had lower risk of death when compared to unscreened patients (HR= 0.53, 95% CI 0.4-0.8). Conclusions: Screening behavior is an important predictor in cervical cancer survival. Study findings highlight the relevance to continue increasing compliance with screening guidelines in PR in order to positively impact patient survival. Citation Format: Vanessa Gómez-Vargas, Israel Almodóvar-Rivera, Karen J Ortiz-Ortiz, Carlos R Torres-Cintrón, Ana P Ortiz-Martínez. Cervical cancer survival analysis based on screening practices and the socioeconomic position index in Puerto Rico [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C023.

Abstract C091: Racial/ethnic disparities in awareness and attitudes towards the HPV vaccine among women living in the United States and Puerto Rico

Abstract Introduction In the United States (US), Human papilomavirus (HPV) is the most common sexually transmitted infection and an infectious agent related to cancer. The HPV vaccine is the most effective preventive method against cervical cancer. Studies have shown racial/ethnic disparities in knowledge and attitudes towards HPV and its vaccine. Few national studies have explored these disparities including Puerto Rican women, a group which higher rates of cervical cancer have been documented. In this study, we examined differences in awareness and attitudes toward the HPV vaccine among a sample of women 18 years of age and older from Puerto Rico (PR) and the US. Methods: We conducted a secondary analysis using data from the Health Information National Trends Survey (HINTS); conducted nationwide in 2007 (n = 4,145 HINTS U.S.) and in PR in 2009 (n = 417; PR). Multivariate logistic regression analysis assessed the association between racial/ethnic group (non-Hispanic White, non- Hispanic Black, Hispanics and PR women and HPV vaccine awareness and attitudes, whilst adjusting for age, education, marital status and health insurance. All analyses were performed using the statistical software SPSS version 23.0. Results: A total of 4,562 women participated in this survey: 72.4% non-Hispanic White, 10.2% non-Hispanic Black, 9.1% Puerto Rican women and 8.3 Hispanics. Hispanics and Puerto Rican women had a higher attitude towards the HPV vaccine (55.9% and 74.8%), respectively. Multivariate logistic regression models shown that, Hispanics women were 68% less likely to have heard that the vaccine prevents cervical cancer, compared to non-Hispanic White women (OR=0.32; 95% IC = 0.25 - 0.42, p&amp;lt;0.001). PR women are 2.4 times more likely of having a positive attitude towards the HPV vaccine compared to non- Hispanic White women in the US (OR=2.41; 95%IC=1.89 - 3.06, p&amp;lt;0.001). Non- Hispanic Black women were 25% less likely to have a positive attitude toward the vaccine when compared to non- Hispanic White women (OR=0.75; 95% IC = 0.61 - 0.93, p&amp;lt;0.001). Conclusion: The women living in PR showed a greater disposition toward the HPV vaccine. Non-Hispanic Black women in the US were least likely to be aware and have positive attitude towards the HPV vaccine. The disparities observed in the different races/ethnicities analyzed in this study, suggest racial and ethnic differences, which deserve further investigation so that health providers can better target educational across different racial/ethnic groups aiming to increase awareness and knowledge about HPV and its vaccination. Citation Format: Nelybeth Santiago Yance, Rafael E Rios McConnell, Mildred Vera Rios, Vivian Colón López. Racial/ethnic disparities in awareness and attitudes towards the HPV vaccine among women living in the United States and Puerto Rico [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C091.