CHDS Senior Research Scientist Nicole Campos ’ modeling study shows that cervical cancer screening uptake among African-American women in the Mississippi Delta may improve and be cost-effective when under-screened women are offered an HPV self-collection intervention.
African-American women in the United States have an elevated risk of cervical cancer and cervical cancer death. These disparities are particularly stark in the Mississippi Delta. A group randomized trial evaluated the efficacy of a patient-centered approach to African-American women in the Delta, comparing “Choice” (in which women were offered a choice between self-collection at home for HPV testing or current standard-of-care screening within the Health Department clinics) and “Standard-of-care screening” within the Health Department clinics. Both trial arms were facilitated by community health workers. Using cost and health service delivery data from the trial, Campos and colleagues used a mathematical model of HPV infection and cervical pathogenesis to project the health and economic impact of “Choice” versus “Standard-of-care screening” among under-screened African-American women in the Delta.
The trial found that the “Choice” intervention led to greater screening uptake than “Standard-of-care screening” at the Health Department, and the accompanying modeling study found that offering “Choice” may be both cost-effective and lead to greater reductions in cervical cancer risk. The authors expressed their hope these findings will lead to interventions and policies that improve screening coverage for under-screened African-American women in the Mississippi Delta, and other regions and populations with significant barriers to screening at the clinic.
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