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Cancer Epidemiol. 2017 Oct;50(Pt B):283-288. doi: 10.1016/j.canep.2017.07.008.

Acceptability and feasibility of a community based participatory research project comparing cytology and urine HPV DNA testing for cervical cancer screening in Yap, Federated States of Micronesia.

Author information

1
Pacific Cancer Projects, John A. Burns School of Medicine, University of Hawaii at Manoa, 677 Ala Moana Blvd #815, Honolulu, HI, 96813, United States. Electronic address: sya@hawaii.edu.
2
Cancer Research Center of Hawaii, University of Hawaii, 701 Ilalo Street, Honolulu, HI, 96813, United States.
3
Yap State Department of Health Services, PO Box 148, Colonia, Yap, 96943, Federated States of Micronesia.
4
Pacific Cancer Projects, John A. Burns School of Medicine, University of Hawaii at Manoa, 677 Ala Moana Blvd #815, Honolulu, HI, 96813, United States.

Abstract

Non-invasive, self-collected sampling methods for HPV DNA detection in women, which are reliable, efficient, and acceptable have the potential to address barriers to cervical cancer screening in underserved communities, including low-middle income countries (LMIC) such as the island nation of the Federated States of Micronesia (FSM). Urine-based HPV testing has not been rigorously evaluated in clinical trials. A pilot community-based participatory randomized control research project evaluated use of urine HPV testing as a more culturally- and human resource appropriate method of cervical cancer screening in Yap State, FSM. Women participated in a cervical screening intervention using pap vs. urine test (N=217). This manuscript described attitudes about screening feasibility and preferences. Stakeholders and women participants were interviewed (N=23), and a survey also evaluated women's screening preferences (N=217). Qualitative content thematic analysis with multiple coders identified themes from interviews on acceptability and feasibility of screening tests. Women research participants were comfortable with the urine test (95%), despite limitations in some to provide samples. While 82.0% indicated that they felt comfortable with Pap smear, they also preferred a clinician (42%) to do the Pap smear, explaining that they preferred having a trained worker instead of themselves to do tests. Women want to be screened but accessibility remains a challenge. Education and training of professionals and community members alike will improve clinical skills, research capacity, knowledge of screening tests and behaviors including prioritizing HPV screening and testing.

KEYWORDS:

Cancer screening; Community based participatory research; Early detection of cancer; Female; Human papillomavirus; Pacific Islands; Papillomavirus infections; Prevention and control; Translational research

PMID:
29120838
PMCID:
PMC5739880
DOI:
10.1016/j.canep.2017.07.008
[Indexed for MEDLINE]
Free PMC Article

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