Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research

Abdi, Hamdi I.; Hoover, Elise; Fagan, Sarah; Adsul, Prajakta

doi:10.1007/s10903-020-01014-5

Cited by 13 publications

(12 citation statements)

References 76 publications

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“…Barriers to traditional Pap test screening in minority women have been documented extensively in the literature. These include psychosocial issues such as embarrassment, pain, and discomfort associated with a pelvic exam and practical issues such as difficulty finding the time to have the test or an acceptable (e.g., gender-concordant) doctor [ 9 , 10 ]. HPV self-sampling was perceived by health care personnel to be more advantageous than traditional Pap tests because of its ease of use, efficiency, comfortability, privacy, and cost- and time-saving benefits.…”

Section: Discussionmentioning

confidence: 99%

“…Surveillance trends continue to point to these stark and ongoing cervical cancer disparities in minority groups. Most notably, Pap tests are still underutilized by many US minority women due to a lack of knowledge of cervical cancer and cervical cancer screening, psychosocial and cultural beliefs, pain associated with pelvic exams, and structural barriers to health care access [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study

Xiong

Lazovich

Hassan

et al. 2022

Implement Sci Commun

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Background Persistent infection with high-risk human papillomavirus (hrHPV) types is a well-documented cause of cervical cancer. Since the implementation of cervical cancer screening methods (e.g., Pap tests), cervical cancer rates have declined. However, Pap tests are still unacceptable to many women and require complex infrastructure and training. Self-sampling techniques for collecting HPV specimens (or “HPV self-sampling”) have been proposed as a possible alternative to overcome these barriers. The objective of this study was to capture perspectives from health care personnel (providers, leaders, and clinic staff) across primary care systems on the potential implementation of an HPV self-sampling practice. Methods Between May and July 2021, a study invitation was emailed to various health care professional networks across the Midwest, including a snowball sampling of these networks. Eligible participants were invited to a 45–60-min Zoom-recorded interview session and asked to complete a pre-interview survey. The survey collected sociodemographics on age, occupation, level of educational attainment, race/ethnicity, gender, and awareness of HPV self-sampling. The semi-structured interview was guided by the Consolidated Framework for Implementation Research and asked participants about their views on HPV self-sampling and its potential implementation. All interviews were audio-recorded, transcribed, and analyzed using NVivo 12. Results Key informant interviews were conducted with thirty health care personnel—13 health care providers, 6 clinic staff, and 11 health care leaders—from various health care systems. Most participants had not heard of HPV self-sampling but reported a general enthusiasm for wanting to implement it as an alternative cervical cancer screening tool. Possible barriers to implementation were knowledge of clinical evidence and ease of integration into existing clinic workflows. Potential facilitators included the previous adoption of similar self-sampling tools (e.g., stool-based testing kits) and key decision-makers. Conclusion Although support for HPV self-sampling is growing, its intervention’s characteristics (e.g., advantages, adaptability) and the evidence of its clinical efficacy and feasibility need to be better disseminated across US primary care settings and its potential adopters. Future research is also needed to support the integration of HPV self-sampling within various delivery modalities (mail-based vs. clinic-based).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study

Xiong

Lazovich

Hassan

et al. 2022

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…These include psychosocial issues such as embarrassment, pain and discomfort associated with a pelvic exam, and practical issues such as di culty nding the time to have the test or an acceptable (e.g., gender-concordant) doctor. [43] Counter to the psychosocial and practical issues associated with Pap tests, HPV self-sampling was perceived by all health care personnel to be easier to use, more e cient, comfortable, private, and cost-and time-saving. Of most importance to health care personnel, was the tool's potential ability to increase reach, especially within underscreened populations, due to its perceived acceptability and decreased invasiveness.…”

Section: Discussionmentioning

confidence: 99%

Health Care Personnel’s Perspectives on Human Papillomavirus (HPV) Self-Sampling for Cervical Cancer Screening: A Pre-Implementation, Qualitative Study

Xiong

Lazovich

Hassan

et al. 2022

Preprint

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Background: Persistent infection with high-risk human papillomavirus (hrHPV) types are well-documented causes of cervical cancer. Since the implementation of cervical cancer screening methods (e.g., Pap tests), cervical cancer rates have declined. However, Pap tests are still unacceptable to many women and require complex infrastructure and training. Self-sampling techniques for collecting HPV specimens (or “HPV self-sampling”) have been proposed as a possible alternative to overcome these barriers. The objective of this study was to understand various health care personnel’s perspectives on the potential implementation of an HPV self-sampling practice in US primary care settings. Methods: Between May – July 2021, a study invitation was emailed to various health care professional networks across the Midwest, including a snowball sampling of these networks. Eligible participants were invited to a 45-60 minute Zoom-recorded interview session and asked to complete a pre-interview survey. The survey collected sociodemographics on age, occupation, level of educational attainment, race/ethnicity, gender, and an awareness of HPV self-sampling. The semi-structured interview was guided by the Consolidated Framework for Implementation Research and asked participants about their views on HPV self-sampling and its potential implementation. All interviews were audio-recorded, transcribed, and analyzed using NVivo 12. Results: Key informant interviews were conducted with thirty health care professionals - 13 health care providers, 6 clinic staff, and 11 health care leaders - from various health care systems. Most participants had not heard of HPV self-sampling but reported a general enthusiasm for wanting to implement it as an alternative cervical cancer screening tool. Possible barriers to implementation were knowledge of clinical evidence and ease of integration into existing clinic workflows. Potential facilitators included previous adoption of similar self-sampling tools (e.g., stool-based testing kits) and key decision-makers.Conclusion: Although support for HPV self-sampling is growing, its intervention’s characteristics (e.g., advantages, adaptability) and the evidence of its clinical efficacy and feasibility needs to be better disseminated across US primary care settings and its potential adopters. Future research is also needed to support the integration of HPV self-sampling within various delivery modalities (mail-based vs. clinic-based).

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“…As providers caring for these women, our responsibility is to recognize the existence of the global disparity in cervical cancer control and be responsive to this to improve health equity. 14,15 We can do this by assessing our migrant and refugee patients' need for culturally tailored education around prevention and screening for cervical cancer, and by continuing to research novel ways of increasing screening for this vulnerable population. 16,17 Although this brief report focuses only on cervical cancer control, it may also serve as a bellwether for increased awareness about disparities related to other cancers and noncommunicable diseases for refugee populations.…”

Section: Discussionmentioning

confidence: 99%

Health Inequity in Cervical Cancer Control Among Refugee Women in the United States by Country of Origin

2021

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Purpose: To describe cervical cancer control practices from common countries of origin for women who resettle in the United States as refugees to highlight this persistent health inequity. Methods: Describe presence/type of national cervical cancer screening program, screening coverage percentage, and human papillomavirus (HPV) vaccination program presence and coverage. Results: Nine of 15 included countries screen opportunistically. Most do not use high-performing tests, and estimates of screening coverage were limited. Only one country offers HPV vaccination. Conclusion: Countries of origin for refugee women may lack effective national cervical cancer control programs. To meet the World Health Organization (WHO)'s call to eliminate cervical cancer by 2030, focus on culturally tailored education, and continued research are paramount.

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Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research

Cited by 13 publications

References 76 publications

Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study

Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study

Health Care Personnel’s Perspectives on Human Papillomavirus (HPV) Self-Sampling for Cervical Cancer Screening: A Pre-Implementation, Qualitative Study

Health Inequity in Cervical Cancer Control Among Refugee Women in the United States by Country of Origin

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