Adherence patterns to extended cervical screening intervals in women undergoing human papillomavirus (HPV) and cytology cotesting

Rendle, Katharine A.; Schiffman, Mark; Cheung, Li C.; Kinney, Walter; Fetterman, Barbara; Poitras, Nancy; Lorey, Thomas; Castle, Philip E.

doi:10.1016/j.ypmed.2017.12.023

Cited by 17 publications

(17 citation statements)

References 35 publications

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“…Demographic findings regarding older age and screening nonadherence are generally consistent with the findings in previous studies (Acera et al, 2014;Östensson et al, 2015). However, this study found that women of Hispanic ethnicity were more likely to be adherent, whereas previous studies showed that Hispanic women had lower screening rates (Byrd et al, 2007;Cronin et al, 2018;Rendle et al, 2018). Interventions like the AMIGAS (Ayudando a las Mujeres con Información, Guía, y Amor para su Salud promotora) program have started to target this population more closely, which may have resulted in improved adherence (Byrd et al, 2013).…”

Section: Discussionsupporting

confidence: 89%

Utilizing a Multidimensional Health Literacy Framework to Assess Cervical Cancer Screening Nonadherence

et al. 2021

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Health literacy is an amenable factor that can improve screening uptake. However, associations between the multidimensional health literacy domains and cervical cancer screening nonadherence are not known and should be considered to improve screening rates. The current quantitative study assessed the associations of multiple health literacy domains with cervical cancer screening nonadherence. Women aged 30 to 65 years without a hysterectomy were surveyed online ( N = 812). Assessing, understanding, and appraising measures from the European Health Literacy Survey Questionnaire were adapted for cervical cancer screening. The outcome variable measured the application of cervical cancer information regarding adherence to the 2012 cervical cancer screening guidelines (yes/no). Adjusted logistic regression odds ratios (aORs) estimated nonadherence. Most of the women were non-Hispanic (81.4%) or White (68.1%), and aged 30 to 39 years (40%). The majority of the women (71%) were adherent to screening recommendations. The model with all domains of health literacy had the best model fit statistics compared with other models with different health literacy components. Older age and lack of insurance were statistically significant for screening nonadherence. Difficulty understanding health information (aOR = 3.15; 95% confidence interval [CI; 1.80, 5.51]) and less worry about cervical cancer (aOR = 1.74; 95% CI [1.03, 2.94]) were associated with higher odds of nonadherence. Higher cervical cancer knowledge (aOR = 0.93; 95% CI [0.87, 0.98]) and Hispanic ethnicity (aOR = 0.36; 95% CI [0.21, 0.61)] were associated with lower odds of nonadherence. Incorporating a multidimensional health literacy framework may better inform the need to develop easily understood interventions that address cervical cancer perceived vulnerability and acknowledge systemic sociodemographic influences on screening perceptions.

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Section: Discussionsupporting

confidence: 89%

Utilizing a Multidimensional Health Literacy Framework to Assess Cervical Cancer Screening Nonadherence

et al. 2021

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“…A national survey of different provider groups (family physicians, nurse practitioners, obstetricians and gynecologists, and certified nurse‐midwives) revealed considerable disparities and variation between and among provider groups in the use of cervical cancer screening tests 159 . Despite recommendations against annual cervical cancer screening from major guideline developing groups, and many years since annual cytology screening was recommended, it is reported that annual cytology testing still is common 160,161 . Likewise, adoption of the 2012 preferred strategy of cotesting for women aged 30 to 65 years had been slow, although recent reports show an upward trend in cotesting among individuals aged 30 to 65 years, 24,25,162 which varied geographically, from 27.5% in Utah to 49.9% in the District of Columbia 163 .…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Fontham

Wolf

Church

et al. 2020

CA A Cancer J Clinicians

626

546

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The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow-up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.

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“…7 Scenarios were simulated in the context of historical HPV vaccination 6 coverage and Kaiser Permanente Northern California screening practice patterns (Supplementary Table 1). 8…”

Section: Scenarios and Assumptionsmentioning

confidence: 99%

Impact of COVID-19-related care disruptions on cervical cancer screening in the United States

Burger

Jansen

Killen³

et al. 2021

J Med Screen

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Objectives To quantify the secondary impacts of the COVID-19 pandemic disruptions to cervical cancer screening in the United States, stratified by step in the screening process and primary test modality, on cervical cancer burden. Methods We conducted a comparative model-based analysis using three independent NCI Cancer Intervention and Surveillance Modeling Network cervical models to quantify the impact of eight alternative COVID-19-related screening disruption scenarios compared to a scenario of no disruptions. Scenarios varied by the duration of the disruption (6 or 24 months), steps in the screening process being disrupted (primary screening, surveillance, colposcopy, excisional treatment), and primary screening modality (cytology alone or cytology plus human papillomavirus “cotesting”). Results The models consistently showed that COVID-19-related disruptions yield small net increases in cervical cancer cases by 2027, which are greater for women previously screened with cytology compared with cotesting. When disruptions affected all four steps in the screening process under cytology-based screening, there were an additional 5–7 and 38–45 cases per one million screened for 6- and 24-month disruptions, respectively. In contrast, under cotesting, there were additional 4–5 and 35–45 cases per one million screened for 6- and 24-month disruptions, respectively. The majority (58–79%) of the projected increases in cases under cotesting were due to disruptions to surveillance, colposcopies, or excisional treatment, rather than to primary screening. Conclusions Women in need of surveillance, colposcopies, or excisional treatment, or whose last primary screen did not involve human papillomavirus testing, may comprise priority groups for reintroductions.

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Adherence patterns to extended cervical screening intervals in women undergoing human papillomavirus (HPV) and cytology cotesting

Cited by 17 publications

References 35 publications

Utilizing a Multidimensional Health Literacy Framework to Assess Cervical Cancer Screening Nonadherence

Utilizing a Multidimensional Health Literacy Framework to Assess Cervical Cancer Screening Nonadherence

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Impact of COVID-19-related care disruptions on cervical cancer screening in the United States

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