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Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study.

Publication ,  Journal Article
Page, CM; Ibrahim, S; Park, LP; Huchko, MJ
Published in: PLoS One
2019

OBJECTIVE: To identify patient factors associated with whether women who screened positive for high-risk human papillomavirus (hrHPV) successfully accessed treatment in a cervical cancer prevention program in Kenya. METHODS: A prospective cohort study was conducted as part of a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya from January 2018 to February 2019. In this larger trial, women underwent hrHPV testing during community health campaigns (CHCs), and hrHPV+ women were referred to government facilities for cryotherapy. For this analysis, we looked at rates of and predictors of presenting for treatment and presenting within 30 days of receiving positive hrHPV results ("timely" presentation). Data came from questionnaires completed at the time of screening and treatment. Multivariable logistic regression was used to identify factors associated with each outcome. RESULTS: Of the 505 hrHPV+ women, 266 (53%) presented for treatment. Cryotherapy was performed in 236 (89%) of the women who presented, while 30 (11%) were not treated: 15 (6%) due to gas outage, six (2%) due to pregnancy, five (2%) due to concern for cervical cancer, and four (2%) due to an unknown or other reason. After adjusting for other factors in the multivariable analysis, higher education level and missing work to come to the CHC were associated with presenting for treatment. Variables that were associated with increased likelihood of timely presentation were missing work to come to the CHC, absence of depressive symptoms, told by someone important to come to the CHC, and shorter distance to the treatment site. CONCLUSION: The majority of hrHPV+ women who did not get treated were lost at the stage of decision-making or accessing treatment, with a small number encountering barriers at the treatment sites. Patient education and financial support are potential areas for intervention to increase rates of hrHPV+ women seeking treatment.

Duke Scholars

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2019

Volume

14

Issue

9

Start / End Page

e0222750

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Prospective Studies
  • Preventive Medicine
  • Papillomavirus Infections
  • Papillomaviridae
  • Middle Aged
  • Mass Screening
  • Kenya
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Page, C. M., Ibrahim, S., Park, L. P., & Huchko, M. J. (2019). Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study. PLoS One, 14(9), e0222750. https://doi.org/10.1371/journal.pone.0222750
Page, Charlotte M., Saduma Ibrahim, Lawrence P. Park, and Megan J. Huchko. “Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study.PLoS One 14, no. 9 (2019): e0222750. https://doi.org/10.1371/journal.pone.0222750.
Page, Charlotte M., et al. “Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study.PLoS One, vol. 14, no. 9, 2019, p. e0222750. Pubmed, doi:10.1371/journal.pone.0222750.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2019

Volume

14

Issue

9

Start / End Page

e0222750

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Prospective Studies
  • Preventive Medicine
  • Papillomavirus Infections
  • Papillomaviridae
  • Middle Aged
  • Mass Screening
  • Kenya
  • Humans