Application of the Carolina Framework for Cervical Cancer Prevention.
Gynecol Oncol
; 132 Suppl 1: S33-40, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24333357
ABSTRACT
OBJECTIVE:
The Carolina Framework for Cervical Cancer Prevention describes 4 main causes of cervical cancer incidence human papillomavirus (HPV) infection, lack of screening, screening errors, and not receiving follow-up care. We present 2 applications of the Carolina Framework in which we identify high-need counties in North Carolina and generate recommendations for improving prevention efforts.METHODS:
We created a cervical cancer prevention need index (CCPNI) that ranked counties on cervical cancer mortality, HPV vaccine initiation and completion, Pap smear screening, and provision of Pap tests to rarely- or never-screened women. In addition, we conducted in-depth interviews with 19 key informants from programs and agencies involved in cervical cancer prevention in North Carolina.RESULTS:
North Carolina's 100 counties varied widely on individual CCPNI components, including annual cervical cancer mortality (median 2.7/100,000 women; range 0.0-8.0), adolescent girls' HPV vaccine initiation (median 42%; range 15%-62%), and Pap testing in the previous 3 years among Medicaid-insured adult women (median 59%; range 40%-83%). Counties with the greatest prevention needs formed 2 distinct clusters in the northeast and south-central regions of the state. Interviews generated 9 recommendations to improve cervical cancer prevention in North Carolina, identifying applications to specific programs and policies in the state.CONCLUSIONS:
This study found striking geographic disparities in cervical cancer prevention need in North Carolina. Future prevention efforts in the state should prioritize high-need regions as well as recommended strategies and applications in existing programs. Other states can use the Carolina Framework to increase the impact of their cervical cancer prevention efforts.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
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Infecções por Papillomavirus
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Disparidades em Assistência à Saúde
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Detecção Precoce de Câncer
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Necessidades e Demandas de Serviços de Saúde
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Qualitative_research
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Screening_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article