Overview of the CDC Cervical Cancer (Cx3) Study: an educational intervention of HPV testing for cervical cancer screening.

Vicki B Benard, Mona Saraiya, April Greek, Nikki A Hawkins, Katherine B Roland, Diane Manninen, Donatus U Ekwueme, Jacqueline W Miller, Elizabeth R Unger
Author Information
  1. Vicki B Benard: 1 Centers for Disease Control and Prevention , Atlanta, Georgia .

Abstract

BACKGROUND: The recommended screening interval when using the Papanicolaou (Pap) and human papillomavirus (HPV) test (co-testing) is 5 years. However because providers are reluctant to extend the screening interval, we launched a study to identify barriers to appropriate use of the co-test and to implement an educational intervention to promote evidence-based screening practices. This article provides an overview of the study including the multi-component intervention and participant demographics.
METHODS: The study was conducted in 15 clinics associated with 6 Federally Qualified Health Centers (FQHCs) in Illinois. Each clinic received HPV tests to administer with routine Pap tests among enrolled patients (n=2,246) and was assigned to a study arm: intervention arm (n=7) received a multi-component educational intervention (small media, academic detailing, and website) for providers and printed educational materials for patients, and control arm (n=8) received printed copies of general guidelines. Clinic coordinators (n=15), providers (n=98), and patients (n=984) completed baseline surveys to assess screening practices.
RESULTS: Providers reported an average age of 41.3 years and were predominately female, non-Hispanic, and white. patients reported an average age of 45.0 years and nearly two-thirds were Hispanic or black. Of the 2,246 patients, 89% had a normal co-test. Lessons learned from the study included the importance of buy-in at a high level in the organization, a champion provider, and a clinical coordinator devoted to the study.
CONCLUSION: Materials from this study can be adapted to educate providers and patients on appropriate use of the co-test and encourage extended screening intervals as a safe and effective practice.

References

  1. Lancet Oncol. 2011 Jul;12(7):663-72 [PMID: 21684207]
  2. Arch Intern Med. 2010 Jun 14;170(11):977-85 [PMID: 20548011]
  3. CA Cancer J Clin. 2012 May-Jun;62(3):147-72 [PMID: 22422631]
  4. Int J Cancer. 2008 Jan 15;122(2):372-6 [PMID: 17935124]
  5. Obstet Gynecol. 2013 Apr;121(4):829-846 [PMID: 23635684]
  6. Cancer Epidemiol Biomarkers Prev. 2005 May;14(5):1143-8 [PMID: 15894664]
  7. Ann Intern Med. 2012 Jun 19;156(12):880-91, W312 [PMID: 22711081]
  8. Am J Prev Med. 2010 Jan;38(1):110-7 [PMID: 20117566]
  9. J Natl Cancer Inst. 2008 Mar 5;100(5):308-20 [PMID: 18314477]
  10. Obstet Gynecol. 2009 Mar;113(3):595-600 [PMID: 19300322]
  11. Prev Med. 2013 Nov;57(5):419-25 [PMID: 23628517]
  12. JAMA. 2002 May 8;287(18):2372-81 [PMID: 11988058]
  13. BMC Health Serv Res. 2011 May 23;11:112 [PMID: 21600059]
  14. Am J Obstet Gynecol. 2011 Nov;205(5):447.e1-8 [PMID: 21840492]
  15. Ann Intern Med. 2009 Nov 3;151(9):602-11 [PMID: 19884621]
  16. Obstet Gynecol. 2009 Dec;114(6):1409-1420 [PMID: 20134296]
  17. J Appl Psychol. 1948 Jun;32(3):221-33 [PMID: 18867058]
  18. Prev Med. 2013 Nov;57(5):641-5 [PMID: 24012831]

Grants

  1. CC999999/Intramural CDC HHS

MeSH Term

Centers for Disease Control and Prevention, U.S.
Early Detection of Cancer
Female
Health Personnel
Humans
Illinois
Mass Screening
Papanicolaou Test
Papillomavirus Infections
Patient Education as Topic
Practice Guidelines as Topic
Practice Patterns, Physicians'
Time Factors
United States
Vaginal Smears

Word Cloud

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