Comparative community outreach to increase cervical cancer screening in the Mississippi Delta

Abstract

Objective To increase participation in cervical cancer screening of under-served women living in the Mississippi Delta, a U.S. population at high risk for cervical cancer Methods We conducted a door-to-door feasibility study of women living in the Mississippi Delta to increase participation in cervical cancer screening in 2009-10. Women (n=119) aged 26-65 years who had not been screened in last 3 years or more, were not pregnant, and had a cervix were offered a choice: clinic-based Pap testing or home self-collection with HPV DNA testing. Results Seventy-seven women (64.7%) chose self-collection with HPV testing, of which 62 (80.5%) returned their self-collected specimen. By comparison, 42 women (35.3%) chose Pap testing, of which 17 (40.5%) attended their clinic appointment. Thus there was an almost 4-fold greater participation of under-screened women in self-collection with HPV testing than in free Pap testing (78.4% vs. 21.5%). Conclusions We found that offering self-collection will increase participation in cervical cancer screening among under-screened populations living in the Mississippi Delta. Based on these preliminary results, we suggest that self-collection with HPV DNA testing might complement current Pap testing programs to reach under-screened populations of women, such as those living in the Mississippi Delta.

Considerations for bio-specimen collection among black women residing in the rural Deep South participating in a cancer prevention study

“…To accomplish this, an academic-community partnership spanning two states (Alabama and Mississippi) and up to 22 counties has been maintained over the past 13 years. Guided by Paulo Friere's empowerment theory (Freire 1970(Freire , 1983) and the community development theory (Butterfoss et al 1993), our partnership has implemented a community-based participatory research (CBPR) approach (Lisovicz et al 2006;Partridge et al 2005) to decrease disparities in cancer screening rates Fouad et al 2010;Castle et al 2011) and reduce behavior risk factors for cancer (Baskin et al 2011). Historically, the DSN has been successful in identifying and training "natural helpers" in the community to function as community health advisors that are trained as research partners (CHARPs) with a primary responsibility of conducting outreach and disseminating cancer prevention messages (Lisovicz et al 2006;Partridge et al 2005;).…”

Comparative Performance of Human Papillomavirus DNA Testing Using Novel Sample Collection Methods

“…Several studies have now evaluated self-collection in combination with the U.S. Food and Drug Administration-approved HPV DNA test, Hybrid Capture 2 (HC2; Qiagen, Gaithersburg, MD), as a potential alternative to cytology (24,32). In the absence of participation in cytology-based programs, HPV DNA testing in self-collected samples might broaden population coverage of cervical cancer screening (6,16). Women can self-sample in their home and attend the clinic only if their HPV result is positive (ca.…”

Consultation rates in cervical screening non-attenders: opportunities to increase screening uptake in GP primary care

“…[10][11][12] Selfsampling for high-risk human papillomavirus (HPV) types has the potential to overcome these; women can take their own test in private, at a time and place of their choosing. Several studies [13][14][15][16][17][18][19] have assessed the uptake of self-sampling for HPV testing in screening non-attenders. Approaches have included posting selfsampling kits directly to women 10,13,15,[19][20][21][22][23] writing to women to ask them to order kits, [15][16][17] and offering kits door-to-door.…”

“…Approaches have included posting selfsampling kits directly to women 10,13,15,[19][20][21][22][23] writing to women to ask them to order kits, [15][16][17] and offering kits door-to-door. 14 Response rates have ranged between 8.7% and 52.1%, and were highest in women who were offered kits in person (ie. door-to-door).…”