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Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya.

Publication ,  Journal Article
Huchko, MJ; Kahn, JG; Smith, JS; Hiatt, RA; Cohen, CR; Bukusi, E
Published in: BMC Cancer
December 6, 2017

BACKGROUND: Despite guidelines for cervical cancer prevention in low-resource countries, a very small proportion of women in these settings undergo screening, and even fewer women are successfully treated. Using pilot data from western Kenya and World Health Organization recommendations, we developed a protocol to implement evidence-based cervical cancer screening and linkage to treatment strategies to the rural communities. We describe the protocol for a cluster-randomized trial to compare two implementation strategies for human-papillomavirus (HPV)-based cervical cancer screening program using metrics described in the RE-AIM (reach, efficacy, adaption, implementation and maintenance) framework. METHODS: The study is a three-year, two-phase cluster-randomized trial in 18 communities in western Kenya. During Phase 1, six control communities were offered screening in health facilities; and six intervention communities were offered screening in community health campaigns. Screening was done with human-papillomavirus testing through self-collected specimens. Phase 1 ended and we are working in partnership with communities to further contextualize the implementation strategy for screening, and develop an enhanced linkage to treatment plan. This plan will be tested in an additional six communities in Phase 2 (enhanced intervention). We will compare the reach, efficacy, cost-effectiveness and adaptability of the implementation strategies. DISCUSSION: Effective low-cost cervical cancer prevention technologies are becoming more widely available in low- and middle-income countries. Despite increasing government support for cervical cancer prevention, there remains a sizeable gap in service availability. We will use implementation science to identify the most effective strategies to fill this gap through development of context-specific evidence-based solutions. This protocol design and results can help guide implementation of cervical cancer screening in similar settings, where women are most underserved and at highest risk for disease. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov , NCT02124252 .

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Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

December 6, 2017

Volume

17

Issue

1

Start / End Page

826

Location

England

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Papillomavirus Infections
  • Papillomaviridae
  • Oncology & Carcinogenesis
  • Molecular Diagnostic Techniques
  • Kenya
  • Humans
 

Citation

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Huchko, M. J., Kahn, J. G., Smith, J. S., Hiatt, R. A., Cohen, C. R., & Bukusi, E. (2017). Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya. BMC Cancer, 17(1), 826. https://doi.org/10.1186/s12885-017-3818-z
Huchko, Megan J., James G. Kahn, Jennifer S. Smith, Robert A. Hiatt, Craig R. Cohen, and Elizabeth Bukusi. “Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya.BMC Cancer 17, no. 1 (December 6, 2017): 826. https://doi.org/10.1186/s12885-017-3818-z.
Journal cover image

Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

December 6, 2017

Volume

17

Issue

1

Start / End Page

826

Location

England

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Papillomavirus Infections
  • Papillomaviridae
  • Oncology & Carcinogenesis
  • Molecular Diagnostic Techniques
  • Kenya
  • Humans