Acceptability of self‐taken vaginal <scp>HPV</scp> sample for cervical screening among an under‐screened Indigenous population

Adcock, Anna; Cram, Fiona; Lawton, Beverley; Geller, Stacie E.; Hibma, Merilyn; Sykes, Peter; MacDonald, Evelyn Jane; Dallas-Katoa, Wendy; Rendle, Bronwyn; Cornell, Tracey; Mataki, Tania; Rangiwhetu, Tania; Gifkins, Naieta; Hart, Selah

doi:10.1111/ajo.12933

Cited by 42 publications

(108 citation statements)

References 22 publications

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“…While not experienced by all Indigenous women, barriers may include: racism; a lack of cultural awareness and sensitivity among health professionals; a lack of culturally appropriate communication available through reminder messages and promotional material; ongoing impacts of colonisation and imposed institutional control and mistreatment leading to a distrust of health services and institutions; perceived lack of confidentiality in services because of kinship relationships; health professionals' use of medical jargon; gender of the health professional; and practical issues including distance to the health service, transport, and financial burden [14][15][16]. Many of these barriers are shared with other Indigenous peoples worldwide [17][18][19][20]. Furthermore, some Indigenous Australians' fatalistic views, beliefs that cancer is contagious and a form of retribution for wrongdoings, feelings of shame, and misunderstandings about the purpose of cancer screening influence their engagement with health services and in cancer prevention programs [21,22].…”

Section: Plos Onementioning

confidence: 99%

“…This option affords women choice and agency over how cervical screening is conducted. Māori women, who frequently reported a need to retain control over their bodies during cervical screening, indicated a preference for HPV self-collection over a clinician-collected sample, providing evidence for the potential for self-collection to restore a sense of control [17].…”

Section: Plos Onementioning

confidence: 99%

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Indigenous Australian women's experiences of participation in cervical screening

et al. 2020

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Aboriginal and Torres Strait Islander (collectively, Indigenous Australian) women experience a higher burden of cervical cancer than other women. The National Cervical Screening Program (NCSP) is failing to meet the needs of Indigenous Australian women, resulting in many women not regularly participating in cervical screening. However, one third of Indigenous Australian women do participate in cervical screening. The reasons that some women in this population commence and continue to screen remain unheard but could provide insights to support women who currently do not participate. We aimed to describe Indigenous Australian women's experiences and views of participation in cervical screening by yarning (a culturally-appropriate interview technique) with 50 Indigenous Australian women aged 25-70 years who had completed cervical screening in the past five years, recruited via Primary Health Care Centres (PHCCs) from three jurisdictions. Aboriginal or Torres Strait Islander women researchers conducted the interviews. Thematic analysis identified six themes: screening as a means of staying strong and in control; overcoming fears, shame, and negative experiences of screening; needing to talk openly about screening; the value of trusting relationships with screening providers; logistical barriers; and overcoming privacy concerns for women employed at PHCCs. Despite describing screening as shameful, invasive, and uncomfortable, women perceived it as a way of staying healthy and exerting control over their health. This ultimately supported their participation and a sense of empowerment. Women valued open discussion about screening and strong relationships with health providers. We identified logistical barriers and specific barriers faced by women employed at PHCCs. This study is strengthened by a research approach that centred Indigenous Australian women's voices. Understanding the experiences of Indigenous Australian women who participate in screening will help screening providers support women to start and continue to screen regularly. Recommendations for practice are provided.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Indigenous Australian women's experiences of participation in cervical screening

et al. 2020

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“…The use of a novel HPV self-sampling technology in un- or under-screened Māori, Pacific and Asian women may improve participation as suggested by recent work in New Zealand [35, 36] and thus partially address the burden of cervical cancer in these populations. However, as recommended by Arbyn et al [27], a local trial is needed to assess feasibility, effectiveness, and cost-effectiveness before the introduction of a programme that includes self-sampling; this is the primary aim of the current study.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two invitation-based methods for human papillomavirus (HPV) self-sampling with usual care among un- and under-screened Māori, Pacific and Asian women: study protocol for a randomised controlled community trial to examine the effect of self-sampling on participation in cervical-cancer screening

et al. 2019

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BackgroundMāori, Pacific and Asian women in New Zealand have lower cervical-cancer screening rates than European women, and there are persistent inequities in cervical cancer outcomes for Māori and Pacific women. Innovative ways to address access barriers are required. New Zealand is transitioning to screening with human papillomavirus (HPV) DNA testing, which could allow women themselves, rather than a clinician, to take the sample. Internationally, self-sampling has been found to increase screening participation rates. The aim of this open-label community-based randomised controlled trial is to investigate whether self-sampling increases screening participation among un- and under-screened Māori, Pacific and Asian women in New Zealand.Methods/designWe aim to invite at least 3550 un- or under-screened (≥5 years overdue) Māori, Pacific and Asian women (1050, 1250, 1250 respectively), aged 30–69 years, for screening. The three study arms are: usual care in which women are invited to attend a clinic for a standard clinician-collected cytology test; clinic-based self-sampling in which women are invited to take a self-sample at their usual general practice; and mail-out self-sampling in which women are mailed a kit and invited to take a self-sample at home. Women will be randomised 3:3:1 to the clinic and mail-out self-sampling groups, and usual care. There is also a nested sub-study in which non-responding women in all allocation groups, when they subsequently present to the clinic for other reasons, are offered clinic or home-kit self-sampling. The primary outcome will be the proportion of women who participate (by taking a self-sample or cytology test).DiscussionThis trial is the first to evaluate the effectiveness of mailed self-sampling in New Zealand and will be one of the first internationally to evaluate the effectiveness of opportunistic in-clinic invitations for self-sampling. The trial will provide robust evidence on the impact on participation proportions from different invitation approaches for HPV self-sampling in New Zealand un- and under-screened Māori, Pacific and Asian women.Trial registrationANZCTR Identifier: ACTRN12618000367246 (date registered 12/3/2018) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371741&isReview=true; UTN: U1111–1189-0531.

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“…Self-sampling for HPV can also help to improve rates of CC screening in areas with limited access to health facilities. 41 - 43 Pilot programs have demonstrated uptake acceptability and efficacy in Uganda, 44 Bolivia, 45 India, 46 among indigenous New Zealanders, 47 and in Peru. 48 As the prevalence of HPV self-sampling increases, this procedure will face some of the same challenges encountered by traditional screening methods, such as lack of knowledge, fear, and distrust.…”

Section: Discussionmentioning

confidence: 99%

Understanding Geospatial Factors Associated With Cervical Cancer Screening Uptake in Amazonian Peruvian Women

Barrett

Paz-Soldán

Mendoza-Cervantes

et al. 2020

JCO Global Oncology

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PURPOSE Cervical cancer (CC) is the most common and second-most deadly cancer among Peruvian women. Access to services is strongly associated with CC screening uptake. This study investigated geospatial features contributing to utilization of screening. We used geolocated data and screening information from a Knowledge, Attitudes, and Practice (KAP) survey implemented in Iquitos, Peru in 2017. MATERIALS AND METHODS The KAP collected cross-sectional CC screening history from 619 female interviewees age 18-65 years within 5 communities of varying urbanization levels. We used spatial statistics to determine if screened households tended to cluster together or cluster around facilities offering screening in greater numbers than expected, given the underlying population density. RESULTS On the basis of K-functions, screened households displayed greater clustering among each other as compared with clustering among unscreened households. Neighborhood-level factors, such as outreach, communication, or socioeconomic condition, may be functioning to generate pockets of screened households. Cross K-functions showed that screened households are generally located closer to health facilities than unscreened households. The significance of facility access is apparent and demonstrates that travel and time barriers to seeking health services must be addressed. CONCLUSION This study highlights the importance of considering geospatial features when determining factors associated with CC screening uptake. Given the observed clustering of screened households, neighborhood-level dynamics should be further studied to understand how they may be influencing screening rates. In addition, results demonstrate that accessibility issues must be carefully considered when designing an effective cancer screening program that includes screening, follow-up, and treatment.

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Acceptability of self‐taken vaginal HPV sample for cervical screening among an under‐screened Indigenous population

Cited by 42 publications

References 22 publications

Indigenous Australian women's experiences of participation in cervical screening

Indigenous Australian women's experiences of participation in cervical screening

Understanding Geospatial Factors Associated With Cervical Cancer Screening Uptake in Amazonian Peruvian Women

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