Addressing unmet social needs to improve equity in cervical cancer prevention

Project Dates: 2021-2022

An estimated 14,480 women will be newly diagnosed with cervical cancer in the U.S. in 2021, leading to 4,290 deaths from this disease. Half of these diagnoses and deaths could be prevented by treating pre-invasive cervical lesions with colposcopy, yet up to 77% of women are lost to follow-up after an abnormal screen. As a result of deeply rooted social and racial disparities in the U.S, low access to colposcopy is especially notable among Black women, women with low incomes, and those living in rural areas, contributing to disproportionately high cervical cancer mortality rates in these groups. To prevent cervical cancer, we must
develop and implement interventions that mitigate social determinants of health and thereby improve equity in colposcopy adherence. The overall goal of this project is to obtain key input from stakeholders (patients, providers, and community stakeholders) regarding the design of our equity-focused appointment reminder system and its ease of implementation.

Project Goals:

  • Identify barriers and facilitators to achieve equity in colposcopy follow-up after an
    abnormal cervical cancer screen.
  • Refine our equity-focused appointment reminder system to enhance dissemination and

Implications for Research and Practice:

The project will provide key data to launch a larger trial to rigorously test the
effectiveness, implementation, and maintenance of our equity-focused appointment reminder system across different patient subgroups (e.g., race/ethnicity, unmet social needs), settings (urban vs. rural), and clinic types (academic vs. community). If such a trial shows that our system is effective, feasible, and acceptable, it can be widely implemented to improve colposcopy adherence and equity in cervical cancer incidence and mortality.

Project Contact: Lindsay Kuroki, MD