| Autor: |
Qin J; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Scarinci I; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Lu E; Family Planning and Reproductive Health Unit, Jhpiego, Johns Hopkins University, Baltimore, Maryland, USA., Senkomago V; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Ngoc Nguyen DT; The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia., Abonales L; Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA., Soin K; Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA., Edilyong J; Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)., Reichhardt M; Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)., Marfel M; Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)., Simms K; The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia., Canfell K; The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia., Maxwell K; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Saraiya M; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Palafox N; Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA. |
| Abstrakt: |
The U.S.-affiliated Pacific Islands (USAPI) have higher cervical cancer incidence and mortality rates and lower screening coverage compared with the United States. This is likely because of economic, geographical, health care delivery, and cultural barriers for women living in these resource-constrained, isolated regions. The most recent U.S. and World Health Organization cervical cancer screening guidelines recommended primary human papillomavirus (HPV) testing as one screening option or the preferred screening modality. Primary HPV screening-based strategies offer several advantages over current screening methods in the USAPI. However, adoption of this newer screening modality has been slow in the United States and not yet incorporated into USAPI screening programs. The U.S. Centers for Disease Control and Prevention and partners initiated the Pacific Against Cervical Cancer (PACe) project in 2019 to evaluate the feasibility, acceptability, and cost-effectiveness of primary HPV testing-based strategies in Guam and in Yap, Federated States of Micronesia. This report provides an overview of the PACe project and outlines the approaches we took in implementing primary HPV testing as a new cervical cancer screening strategy (including the option of self-sampling in Yap), encompassing four core components: (1) community engagement and education, (2) medical and laboratory capacity building, (3) health information and system improvement, and (4) modeling and cost-effectiveness analysis. The PACe project provides examples of systematic implementation and resource appropriate technologies to the USAPI, with broader implications for never screened and under-screened populations in the United States and Pacific as they face similar barriers to accessing cervical cancer screening services. |
