Effect of a female community health volunteer-delivered intervention to increase cervical cancer screening uptake in Nepal: a cluster randomized controlled trial

Shrestha, Aamod Dhoj; Gyawali, Bishal; Shrestha, Archana; Shrestha, Sadeep; Neupane, Dinesh; Ghimire, Sarita; Campbell, Christine; Kallestrup, Per

doi:10.1016/j.pmedr.2022.101948

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…There are multiple social and structural barriers identi ed that disproportionately impact underserved populations, like the population seen in Mississippi's public health system [16][17]. Further research is needed to explore these barriers and facilitators that impact individual follow-up to cervical cancer care in Mississippi to address identi ed disparities and follow-up care [20][21][22][23]. In relation to the 18.48% (of the total n = 1,458) of individuals who returned for a repeat co-test instead of the recommended colposcopy, further research is necessary to understand patient's perspective.…”

Section: Strength/ Limitationsmentioning

confidence: 99%

Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi

Reaves,

Hall,

Stewart

et al. 2024

Preprint

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Purpose: Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. Methods: The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. Results: Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Based on age, individuals 30 + were more likely to follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up colposcopy guidelines (p < .001). Conclusion: Despite high cervical cancer screening rates among Mississippians, a substantial portion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.

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Section: Strength/ Limitationsmentioning

confidence: 99%

Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi

Reaves,

Hall,

Stewart

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Evaluation of follow-up colposcopy procedures after abnormal cervical screening result across a statewide study in Mississippi

Reaves,

Hall,

Stewart

et al. 2024

Cancer Causes Control

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Purpose Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. Methods The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. Results Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented colposcopy follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Individuals 30 + were more likely to have follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up guidelines (p < .001). In total, we found that 78% of individuals had some type of follow-up, including a repeat screening visit. Conclusion Despite high cervical cancer screening rates among Mississippians, a substantial proportion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.

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Strengthening primary health care through community health workers in South Asia

Shrestha,

Afsana,

Weerasinghe

et al. 2024

The Lancet Regional Health - Southeast Asia

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Effect of a female community health volunteer-delivered intervention to increase cervical cancer screening uptake in Nepal: a cluster randomized controlled trial

Cited by 4 publications

References 37 publications

Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi

Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi

Evaluation of follow-up colposcopy procedures after abnormal cervical screening result across a statewide study in Mississippi

Strengthening primary health care through community health workers in South Asia

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