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Community-Based Screening for Cervical Cancer: A Feasibility Study of Rural Appalachian Women
Open accessAbstract
OBJECTIVES: To describe women's comfort levels and perceptions about their experience self-collecting cervicovaginal swabs for human papillomavirus (HPV) testing, to determine whether nurse-guided patient navigation increases the odds of women receiving a traditional Papanicolaou (Pap) test after HPV screening, and to test the hypothesis that women testing positive for oncogenic HPV would be more likely to have a subsequent Pap test than those testing negative. METHODS: A total of 400 women were recruited from 8 rural Appalachian counties, in 2013 and 2014. After completing a survey, women were provided instructions for self-collecting a cervicovaginal swab. Specimens were tested for 13 oncogenic HPV types. Simultaneously, women were notified of their test results and offered initial navigation for Pap testing. Chart-verified Pap testing within the next 6 months served as the end point. RESULTS: Comfort levels with self-collection were high: 89.2% indicated that they would be more likely to self-collect a specimen for testing, on a regular basis, compared with Pap testing. Thirty women (7.5%) had a follow-up Pap test. Women receiving added nurse-guided navigation efforts were significantly less likely to have a subsequent test (P = 0.01). Women testing positive for oncogenic HPV were no more likely than those testing negative to have a subsequent Pap test (P = 0.27). Data were analyzed in 2014. CONCLUSIONS: Rural Appalachian women are comfortable self-collecting cervicovaginal swabs for HPV testing. Furthermore, efforts to recontact women who have received an oncogenic HPV test result and an initial navigation contact may not be useful. Finally, testing positive for oncogenic HPV may not be a motivational factor for subsequent Pap testing.
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“To increase screening coverage, HPV testing has been offered to women via self-collection, removing the need for a pelvic exam, clinic setting and a trained provider [12–17].”
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“Though other studies have compared HPV collection through clinician versus self-sampling [18] only a few studies have provided self-sampling in community settings [15, 19]”
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“Studies have confirmed a high acceptability to HPV self-sampling in different settings [15, 18, 19].”
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Research works printed but not linked: 26
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Cited by
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Oketch, S. Y., Kwena, Z., Choi, Y., Adewumi, K., Moghadassi, M., Bukusi, E. A., & Huchko, M. J. (2019) · BMC Women's Health · doi:10.1186/s12905-019-0778-2 · Cited by 77
Gottschlich, A., Rivera-Andrade, A., Grajeda, E., Alvarez, C., Mendoza Montano, C., & Meza, R. (2017) · Journal of Global Oncology · doi:10.1200/jgo.2016.005629 · Cited by 72
Metadata
- Authors
- Crosby, R. A., Hagensee, M. E., Vanderpool, R., Nelson, N., Parrish, A., Collins, T., & Jones, N.
- Affiliations
- University of Kentucky (US)
- Louisiana State University Health Sciences Center New Orleans (US)
- Corresponding author
- Crosby, Richard A.
- Vanderpool, Robin
- Parrish, Adam
- Collins, Tom
- Jones, Nebraska
- Venue
- Sexually Transmitted Diseases
- Published
- 2015-11
- Volume
- 42
- Issue
- 11
- Pages
- 607-611
- ISSN
- 0148-5717 (ISSN-L)
- PMC
- PMC4608378
- OpenAlex
- W2430398338
- Cited by
- 31
- References
- 0
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 1 · 2017: 10 · 2016: 1
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH092226)
- National Center for Chronic Disease Prevention and Health Promotion (U48 DP005014, 1U48DP00193201, U48DP001932)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer screening, HPV self-testing, high-risk HPV
- MeSH terms
- Adult, Appalachian Region, Uterine Cervical Neoplasms, DNA, Viral, Feasibility Studies, Female, Humans, Kentucky, Mass Screening, Medically Underserved Area, Middle Aged, Patient Acceptance of Health Care, Rural Population, Self Care, Specimen Handling, Vaginal Smears, Women's Health, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer, Papanicolaou Test
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