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Reaves S, Hall KC, Stewart MW, Wentzensen N, Ferrell C, Risley C, Wells J, Rives R, Bobo F, Daniels J, Farrington K, Morgan JC, Clarke MA. Evaluation of follow-up colposcopy procedures after abnormal cervical screening result across a statewide study in Mississippi. Cancer Causes Control 2024:10.1007/s10552-024-01905-0. [PMID: 39152278 DOI: 10.1007/s10552-024-01905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. METHODS The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. RESULTS Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented colposcopy follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Individuals 30 + were more likely to have follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up guidelines (p < .001). In total, we found that 78% of individuals had some type of follow-up, including a repeat screening visit. CONCLUSION Despite high cervical cancer screening rates among Mississippians, a substantial proportion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.
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Affiliation(s)
- Sydney Reaves
- School of Nursing, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA.
| | - Katherine C Hall
- School of Nursing, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Mary W Stewart
- School of Nursing, Mississippi State University, Meridian, MS, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology & Genetics, Clinical Genetics Branch, National Cancer Institute, Rockville, MD, USA
| | - Christina Ferrell
- School of Nursing, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Carolann Risley
- School of Nursing, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
- Cancer Research Institute, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jimmie Wells
- School of Nursing, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Rhonda Rives
- Department of Pathology, Mississippi Baptist Medical Center, Jackson, MS, USA
| | - Fajada Bobo
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jon Daniels
- Mississippi State Department of Health, Jackson, MS, USA
| | | | - Jody C Morgan
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Megan A Clarke
- Division of Cancer Epidemiology & Genetics, Clinical Genetics Branch, National Cancer Institute, Rockville, MD, USA
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Reaves S, Hall KC, Stewart MW, Wentzensen N, Ferrell C, Risley C, Wells J, Rives R, Bobo F, Daniels J, Farrington K, Morgan JC, Clarke MA. Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi. RESEARCH SQUARE 2024:rs.3.rs-3943646. [PMID: 38410464 PMCID: PMC10896379 DOI: 10.21203/rs.3.rs-3943646/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Purpose Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. Methods The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. Results Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Based on age, individuals 30 + were more likely to follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up colposcopy guidelines (p < .001). Conclusion Despite high cervical cancer screening rates among Mississippians, a substantial portion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.
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Affiliation(s)
- Sydney Reaves
- University of Mississippi Medical Center, School of Nursing
| | | | | | | | | | - Carolann Risley
- University of Mississippi Medical Center, Cancer Research Institute
| | - Jimmie Wells
- University of Mississippi Medical Center, School of Nursing
| | - Rhonda Rives
- Mississippi Baptist Medical Center, Department of Pathology
| | - Fajada Bobo
- University of Mississippi Medical Center, Department of Pathology
| | | | | | - Jody C Morgan
- University of Mississippi Medical Center, School of Medicine
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Wilding S, O'Connor DB, Conner M. Social Norms in Cervical Cancer Screening. Psychol Rep 2023:332941231219943. [PMID: 38048215 DOI: 10.1177/00332941231219943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Cancer screening aims to check the body for cancer before symptoms develop. Social norms theory suggests people falsely perceive the attitudes and/or behaviours of similar others to be different from their own and correcting these perceptions can lead to behaviour change. Across two studies, we tested if women underestimate peer levels of cervical screening behaviour and whether a social norms manipulation increases intention to attend cervical cancer screening. In study 1, participants completed a survey on cervical cancer screening norms. In study 2, participants were randomised to receive no norm information, norm information, or norm information plus statement on value of norms in decision making. In study 1, participant estimates of peer level of cervical screening behaviour were significantly lower than nationally reported levels. In study 2, a social norm plus value statement intervention led to stronger intentions to attend screening. This effect was consistent across demographic factors and screening status. Participants significantly underestimate rates of cervical screening behaviour in their peers. A brief, online social norms plus values manipulation increased intentions to attend cervical cancer screening across all groups.
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Affiliation(s)
- Sarah Wilding
- School of Psychology, University of Leeds, Leeds, UK
| | | | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK
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