Cervical Cancer Screening in the United States-Affiliated Pacific Islands: Options and Opportunities
Authors
Waxman, Alan G.Buenconsejo-Lum, Lee E.
Cremer, Miriam
Feldman, Sarah
Ault, Kevin A.
Cain, Joanna
Diaz, Maria Lina.
UMass Chan Affiliations
Department of Obstetrics and Gynecology, Division of Gynecologic OncologyDocument Type
Journal ArticlePublication Date
2016-01-01Keywords
Female Urogenital Diseases and Pregnancy ComplicationsMaternal and Child Health
Obstetrics and Gynecology
Women's Health
Metadata
Show full item recordAbstract
OBJECTIVE: Successful cervical cancer screening in the United States-Affiliated Pacific Islands (USAPI) is limited by geographic, political, economic, and logistic factors. An expert panel convened to examine screening in each of the 6 island jurisdictions and to explore options beyond cytology-based screening. MATERIALS AND METHODS: Forty-one representatives of American Congress of Obstetrics and Gynecology, American Society for Colposcopy and Cervical Pathology, government agencies, the World Health Organization, Pan American Health Organization, health representatives of the 6 Pacific island jurisdictions, Puerto Rico, and several academic institutions met in a 2-day meeting to explore options to improve access and coverage of cervical cancer screening in the USAPI. RESULTS: Cytology-based screening is less widely accessed and less successful in the USAPI than in the United States in general. Barriers include geographic isolation, cultural factors, and lack of resources. Cytology-based screening requires multiple visits to complete the process from screening to treatment. Screen-and-treat regimens based on visual inspection with acetic acid or human papillomavirus requiring 1 or 2 visits have the potential to improve cervical cancer prevention in the USAPI. CONCLUSIONS: The standard US algorithm of cytology screening followed by colposcopy and treatment is less effective in geographically and culturally isolated regions such as the USAPI. Alternate technologies, both high tech, such as primary human papillomavirus screening, and low tech, such as visual inspection with acetic acid, have shown promise in resource-poor countries and may have applicability in these US jurisdictions.Source
J Low Genit Tract Dis. 2016 Jan;20(1):97-104. doi: 10.1097/LGT.0000000000000161. Link to article on publisher's siteDOI
10.1097/LGT.0000000000000161Permanent Link to this Item
http://hdl.handle.net/20.500.14038/42786PubMed ID
26704332Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/LGT.0000000000000161