Dataset Information

Cervical Cancer Screening in the United States-Affiliated Pacific Islands: Options and Opportunities.

ABSTRACT: Successful cervical cancer screening in the United States-Affiliated Pacific Islands (USAPI) is limited by geographic, political, economic, and logistic factors. An expert panel convened to examine screening in each of the 6 island jurisdictions and to explore options beyond cytology-based screening.Forty-one representatives of American Congress of Obstetrics and Gynecology, American Society for Colposcopy and Cervical Pathology, government agencies, the World Health Organization, Pan American Health Organization, health representatives of the 6 Pacific island jurisdictions, Puerto Rico, and several academic institutions met in a 2-day meeting to explore options to improve access and coverage of cervical cancer screening in the USAPI.Cytology-based screening is less widely accessed and less successful in the USAPI than in the United States in general. Barriers include geographic isolation, cultural factors, and lack of resources. Cytology-based screening requires multiple visits to complete the process from screening to treatment. Screen-and-treat regimens based on visual inspection with acetic acid or human papillomavirus requiring 1 or 2 visits have the potential to improve cervical cancer prevention in the USAPI.The standard US algorithm of cytology screening followed by colposcopy and treatment is less effective in geographically and culturally isolated regions such as the USAPI. Alternate technologies, both high tech, such as primary human papillomavirus screening, and low tech, such as visual inspection with acetic acid, have shown promise in resource-poor countries and may have applicability in these US jurisdictions.

SUBMITTER: Waxman AG

PROVIDER: S-EPMC5672793 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Publications

Cervical Cancer Screening in the United States-Affiliated Pacific Islands: Options and Opportunities.

Waxman Alan G AG Buenconsejo-Lum Lee E LE Cremer Miriam M Feldman Sarah S Ault Kevin A KA Cain Joanna M JM Diaz Maria Lina ML

Journal of lower genital tract disease 20160101 1

<h4>Objective</h4>Successful cervical cancer screening in the United States-Affiliated Pacific Islands (USAPI) is limited by geographic, political, economic, and logistic factors. An expert panel convened to examine screening in each of the 6 island jurisdictions and to explore options beyond cytology-based screening.<h4>Materials and methods</h4>Forty-one representatives of American Congress of Obstetrics and Gynecology, American Society for Colposcopy and Cervical Pathology, government agencie ...[more]

PMID: 26704332

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Project description:Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, † USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau).§ Differences in vaccination coverage between main and outer islands¶ were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ?4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ?3 doses of inactivated poliovirus vaccine (IPV); ?1 dose of measles, mumps, and rubella vaccine (MMR); ?3 doses of Haemophilus influenzae type B (Hib) vaccine; ?3 doses of hepatitis B (HepB) vaccine; and ?4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ?3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines†† was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions, is essential to maintain protection from VPD outbreaks in the region and the mainland United States.

Dataset Information

Cervical Cancer Screening in the United States-Affiliated Pacific Islands: Options and Opportunities.

Publications

Cervical Cancer Screening in the United States-Affiliated Pacific Islands: Options and Opportunities.

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