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Cited by 18Cervical Cancer and HPV ResearchHealth Policy Implementation ScienceWomen's cancer prevention and management

Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya

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Huchko, Megan J., Kahn, James G., Smith, Jennifer S., Hiatt, Robert A., Cohen, Craig R., Bukusi, Elizabeth·2017·BMC Cancer
DOI 10.1186/s12885-017-3818-zPMC PMC5717798
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Abstract

BACKGROUND: Despite guidelines for cervical cancer prevention in low-resource countries, a very small proportion of women in these settings undergo screening, and even fewer women are successfully treated. Using pilot data from western Kenya and World Health Organization recommendations, we developed a protocol to implement evidence-based cervical cancer screening and linkage to treatment strategies to the rural communities. We describe the protocol for a cluster-randomized trial to compare two implementation strategies for human-papillomavirus (HPV)-based cervical cancer screening program using metrics described in the RE-AIM (reach, efficacy, adaption, implementation and maintenance) framework. METHODS: The study is a three-year, two-phase cluster-randomized trial in 18 communities in western Kenya. During Phase 1, six control communities were offered screening in health facilities; and six intervention communities were offered screening in community health campaigns. Screening was done with human-papillomavirus testing through self-collected specimens. Phase 1 ended and we are working in partnership with communities to further contextualize the implementation strategy for screening, and develop an enhanced linkage to treatment plan. This plan will be tested in an additional six communities in Phase 2 (enhanced intervention). We will compare the reach, efficacy, cost-effectiveness and adaptability of the implementation strategies. DISCUSSION: Effective low-cost cervical cancer prevention technologies are becoming more widely available in low- and middle-income countries. Despite increasing government support for cervical cancer prevention, there remains a sizeable gap in service availability. We will use implementation science to identify the most effective strategies to fill this gap through development of context-specific evidence-based solutions. This protocol design and results can help guide implementation of cervical cancer screening in similar settings, where women are most underserved and at highest risk for disease. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov , NCT02124252 .

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Cited by

Sorted by citations

Authors
Huchko, M. J., Kahn, J. G., Smith, J. S., Hiatt, R. A., Cohen, C. R., & Bukusi, E.
Affiliations
  • Duke University (US)
  • University of California, San Francisco (US)
  • University of North Carolina at Chapel Hill (US)
  • University of Nairobi (KE)
Corresponding author
Huchko, Megan J.
ORCID
Venue
BMC Cancer
Publisher
Springer Science and Business Media LLC
Published
2017-12
Volume
17
Issue
1
Pages
826-826
ISSN
1471-2407 (ISSN-L)
DOI
10.1186/s12885-017-3818-z
PMC
PMC5717798
OpenAlex
W2772873441
Cited by
18
References
1
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 3
FWCI
2.36
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cancer (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Cancer Institute (R01-CA188428)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
cervical cancer screening, HPV testing, community health campaign, linkage to treatment, self-collected samples, implementation strategies, RE-AIM framework, rural women, resource-limited settings, Western Kenya, cost-effectiveness
MeSH terms
Uterine Cervical Neoplasms, DNA, Viral, Female, Humans, Kenya, Risk Factors, Vaginal Smears, Cluster Analysis, Randomized Controlled Trials as Topic, Molecular Diagnostic Techniques, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer

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