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Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya
Author(s) -
Huchko Megan J.,
Ibrahim Saduma,
Blat Cinthia,
Cohen Craig R.,
Smith Jennifer S.,
Hiatt Robert A.,
Bukusi Elizabeth
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12415
Subject(s) - medicine , cervical cancer , community health , population , cervical cancer screening , cancer , cancer screening , randomized controlled trial , family medicine , cervical screening , public health , gynecology , environmental health , demography , nursing , sociology
Abstract Objective To determine the effectiveness of community health campaigns ( CHC s) as a strategy for human papillomavirus ( HPV )‐based cervical cancer screening in rural western Kenya. Methods Between January and November 2016, a cluster‐randomized trial was carried out in 12 communities in western Kenya to investigate high‐risk HPV testing offered via self‐collection to women aged 25–65 years in CHC s versus government health facilities. Outcome measures were the total number of women accessing cervical cancer screening and the proportion of HPV ‐positive women accessing treatment. Results In total, 4944 women underwent HPV ‐based cervical cancer screening in CHC s (n=2898) or health facilities (n=2046). Screening uptake as a proportion of total eligible women in the population was greater in communities assigned to CHC s (60.0% vs 37.0%, P <0.001). Rates of treatment acquisition were low in both arms ( CHC s 39.2%; health facilities 31.5%; P =0.408). Discussion Cervical cancer screening using HPV testing of self‐collected samples reached a larger proportion of women when offered through periodic CHC s compared with health facilities. The community‐based model is a promising strategy for cervical cancer prevention. Lessons learned from this trial can be used to identify ways of maximizing the impact of such strategies through greater community participation and improved linkage to treatment. ClinicalTrials.gov registration : NCT 02124252.