Among Hispanic women, both incidence and mortality rates from cervical cancer are twice as high as those of non-Hispanic women, and rates of invasive cancer at diagnosis are significantly higher than for non-Hispanic whites. Data from Los Angeles County indicate that the average annual age-adjusted incidence rate of cervical cancer is 21.7 for Latinas versus 9.5 for non-Hispanic whites (per 100,000). Cancer screening can improve survival only if screening results in detection and treatment at an early stage of disease. Less-than-optimal adherence or non-adherence to abnormal screening follow-up can range as high as 60% among Hispanic women. During a four-year CDC funded study, Project SAFe, a highly structured telephone-based education, counseling, and case management intervention designed to increase follow-up adherence after an abnormal Pap screen has been piloted and evaluated. The intervention is also being tested in a randomized study of 200 women. The pilot study included 165 women with abnormal Pap test results: 94 with High-Grade Squamous Intraepithelial Lesions (HGSIL), and 71 with Low-Grade Squamous Intraepithelial Lesions (LGSIL). Results showed 88.5% and 81.7% respective adherence to first follow-up appointment. The most frequently reported barriers to follow-up included a fear of finding cancer, a lack of understanding of follow-up exams, worries about exams or treatment, and concerns about exam costs.
Learning Objectives: At the conclusion of this presentation, participants will be able to (1) Identify culturally-specific barriers to abnormal Pap screening follow-up adherence among Latinas, and (2) Describe four key considerations for implementation of Project SAFe in diverse settings.
Keywords: Cancer Screening, Adherence
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Centers for Disease Control; Los Angeles Co. + USC Medical Center
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.