153531 Discovering a culturally-appropriate alternative to the Pap smear for Haitian American women: The Fournier self-sampling device

Monday, November 5, 2007: 9:05 AM

Lindley Barbee, PhD , University of Miami Miller School of Medicine, Miami, FL
Erin Kobetz, PhD, MPH , Department of Epidemiology and Public Health, University of Miami, Leonard Miller School of Medicine, Miami, FL
Jenny Blanco, MPH , Division of Cancer Prevention and Control, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
Pascale Auguste , Hatian American Association Against Cancer, Miami, FL
Jennifer Hu, PhD , Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Thomas M. Hooton, MD , Institute for Women's Health, University of Miami Leonard M. Miller School of Medicine, Miami, FL
Joseph Lucci, MD , Department of Obstetrics and Gynecology, Director of Gynecologic Oncology, University of Miami Miller School of Medicine, Miami, FL
Ty Swartzlander , University of Miami Leonard M. Miller School of Medicine, Miami, FL
Brittany Ashlock , University of Miami Leonard M. Miller School of Medicine, Miami, FL
Rachel Becker , University of Miami Leonard M. Miller School of Medicine, Miami, FL
Background/significance: Cervical cancer incidence has decreased substantially in the US due to adoption of the Pap smear. However, in Little Haiti, the predominately Haitian neighborhood in Miami, Florida, the incidence of invasive cervical carcinoma remains high. Numerous barriers, including poverty, limited access to healthcare, language difficulties, and cultural norms preclude Haitian women from obtaining regular Pap smears.

Objective/purpose: Our community-based research project examined the acceptability of the Fournier self-sampling device as an alternative screening technique among women in Little Haiti. The Fournier device has similar efficacy for detecting cervical dysplasia as the Pap smear, yet enables women to be screened within their home. This approach circumvents many of the barriers to routine screening among Haitian women.

Methods: Creole-speaking, Haitian Community Health Workers canvassed door-to-door in Little Haiti to identify 350 women who met study eligibility criteria. Women who agreed to participate used the Fournier self-sampler and completed a short interview assessing cervical cancer knowledge and experience using the self-sampler.

Results: Preliminary findings indicate that the majority of Haitian women have limited knowledge of cervical cancer. Moreover, when asked about their experience using the Fournier self-sampler, study participants indicated that the device was easy to use and preferable to a Pap smear.

Discussion/conclusions: The excess incidence of invasive cervical carcinoma among Haitian women necessitates identifying a culturally-appropriate alternative to the Pap smear for this population sub-group. The Fournier self-sampler may be one such alternative, and may have similar benefits for other underserved, immigrant women.

Learning Objectives:
1. Identify Haitian women’s barriers to routine cervical cancer screening 2. Understand the benefit of using the Fournier self-sampling in Little Haiti, Florida 3. Discuss potential expansion of this approach for other underserved communities

Keywords: Cervical Cancer, Underserved Populations

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Fournier self sampling device is a class II medical device that requires FDA clearance for use. The FDA has granted an investigational device exemption (IDE) for the device so that it may be used in clinical investigations.

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.