The development and evaluation of a community based model for cervical cancer screening based on self-sampling.
OBJECTIVE
To develop and implement a community based model for cervical cancer prevention that allows the communities to manage the screening and the healthcare system to focus resources on evaluation and management of the positives.


METHODS
Using self-sampling and the concepts founded in Community Based Participatory Research (CBPR), we progressively developed a model to efficiently reach the women, especially rural communities; and collect the volume of samples needed to support high throughput centralized low cost per case processing.


RESULTS
8382 eligible women, ages 35 to 59, in 130 rural communities participated. The screening was organized by the local government administration and conducted by the community leaders (CLs). The model used was progressively designed through detailed assessment of key elements at 6 decision points in 26 workshops that were used to train the CLs and the local promoters. The communities were able to accurately conduct the screening; in the final model a local medical worker conducted a 50-minute workshop featuring instructional posters and structured role-play. A manual and a workshop DVD were created for distribution to and implementation by local governments. The average callback rate was 84.3%, without involvement of the local doctors in the management of the positives.


CONCLUSIONS
An efficient community based model capable of massive screening events was developed. We believe that the callback rate will be further improved when local doctors are trained in the management of the positives. Many elements impact coverage and further research is needed to define the influence of the identified key variables.
Preventive Oncology International, Cleveland Heights, OH, USA; The Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: jlb@poiinc.org.
Jerome L
JL
Belinson
Dept of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China.
Guixiang
G
Wang
Preventive Oncology International, Cleveland Heights, OH, USA.
Xinfeng
X
Qu
Dept of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China.
Hui
H
Du
Dept of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China.
Jingjing
J
Shen
BGI Shenzhen, Shenzhen, PR China.
Jiajia
J
Xu
The Maternity and Child Health Hospital, Heshan, Guangdong, PR China.
Liqun
L
Zhong
BGI Shenzhen, Shenzhen, PR China.
Ji
J
Yi
BGI Shenzhen, Shenzhen, PR China.
Xin
X
Yi
Dept of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China.
Ruifang
R
Wu
D000328:Adult; D003153:Community Health Services / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012424:Rural Population; D012648:Self Care / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control
Cancer prevention; Cervical cancer; Community based model; Screening; Self-sampling