title: Current cervical cancer screening knowledge, awareness, and practices among U.S. affiliated pacific island providers: opportunities and challenges.
abstract: BACKGROUND
  Cervical cancer is a leading cause of cancer mortality in nearly all U.S. Affiliated Pacific Island Jurisdictions (USAPIJ); however, most jurisdictions are financially and geographically limited in their capacity to deliver routine screening.
  
  
  METHODS
  We conducted a cross-sectional survey of 72 health care providers from five of the six USAPIJ in 2011 to assess knowledge, beliefs, practices, and perceived barriers regarding routine cervical cancer screening. We compared the responses of providers from jurisdictions that were funded by the Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) with those that were not funded.
  
  
  RESULTS
  Most providers reported cervical cancer prevention as a priority in their clinical practices (90.3%) and use the Papanicolaou test for screening (86.1%). Many providers reported knowledge of screening guidelines (76.4%); however, more than half reported that annual screening is most effective (56.9%). Providers in non-NBCCEDP-funded jurisdictions reported greater acceptance of visual inspection with acetic acid (93.9%) and self-sampling for human papillomavirus testing (48.5%) compared with NBCCEDP-funded jurisdictions (15.4% and 30.8% respectively). Providers from non-NBCCEDP-funded jurisdictions reported inadequate technological resources for screening women (42.4%), and approximately 25% of providers in both groups believed that screening was cost-prohibitive.
  
  
  CONCLUSIONS
  Although cervical cancer screening is a priority in clinical practice, beliefs about annual screening, costs associated with screening, and varying levels of support for alternative screening tests pose barriers to providers throughout the USAPIJ. Further exploration of using evidence-based, lower cost, and sustainable screening technologies is warranted in addition to emphasizing timely follow-up of all positive cases.
authors.affiliation: Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia, USA; Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
authors.forename: Julie S
authors.initials: JS
authors.lastname: Townsend
authors.forename: Analía Romina
authors.initials: AR
authors.lastname: Stormo
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Roland
authors.forename: Lee
authors.initials: L
authors.lastname: Buenconsejo-Lum
authors.forename: Susan
authors.initials: S
authors.lastname: White
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male; D044468:Native Hawaiian or Pacific Islander; D010139:Pacific Islands; D065006:Papanicolaou Test; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears
keywords: Cancer screening; Diagnosis; Early detection of cancer; Female; Pacific Islands; Papillomavirus infections; Prevention and control; Uterine cervical neoplasms