Community-based screening for cervical cancer: A feasibility study of rural appalachian women

Richard A. Crosby, Michael E. Hagensee, Robin Vanderpool, Nia Nelson, Adam Parrish, Tom Collins, Nebraska Jones

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objectives: To describe women's comfort levels and perceptions about their experience self-collecting cervicovaginal swabs for human papillomavirus (HPV) testing, to determine whether nurse-guided patient navigation increases the odds of women receiving a traditional Papanicolaou (Pap) test after HPV screening, and to test the hypothesis that women testing positive for oncogenic HPVwould bemore likely to have a subsequent Pap test than those testing negative. Methods: A total of 400 women were recruited from 8 rural Appalachian counties, in 2013 and 2014. After completing a survey, women were provided instructions for self-collecting a cervicovaginal swab. Specimens were tested for 13 oncogenic HPV types. Simultaneously, women were notified of their test results and offered initial navigation for Pap testing. Chart-verified Pap testing within the next 6 months served as the end point. Results: Comfort levels with self-collection were high: 89.2% indicated that they would be more likely to self-collect a specimen for testing, on a regular basis, compared with Pap testing. Thirty women (7.5%) had a follow-up Pap test. Women receiving added nurse-guided navigation efforts were significantly less likely to have a subsequent test (P = 0.01). Women testing positive for oncogenic HPV were no more likely than those testing negative to have a subsequent Pap test (P = 0.27). Data were analyzed in 2014. Conclusions: Rural Appalachian women are comfortable self-collecting cervicovaginal swabs for HPV testing. Furthermore, efforts to recontact women who have received an oncogenic HPV test result and an initial navigation contact may not be useful. Finally, testing positive for oncogenic HPV may not be a motivational factor for subsequent Pap testing.

Original languageEnglish
Pages (from-to)607-611
Number of pages5
JournalSexually Transmitted Diseases
Issue number11
StatePublished - 2015

Bibliographical note

Publisher Copyright:
© 2015 American Sexually Transmitted Diseases Association All rights reserved.

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases


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