title: Increasing Efforts to Reduce Cervical Cancer through State-Level Comprehensive Cancer Control Planning.
abstract: Reducing cervical cancer disparities in the United States requires intentional focus on structural barriers such as systems and policy that impact access to human papillomavirus (HPV) vaccination, cervical cancer screening, and treatment. Such changes are difficult and often politicized. State comprehensive cancer control (CCC) plans are vehicles that, if designed well, can help build collective focus on structural changes. Study objectives were to identify the prioritization of cervical cancer in state CCC plans, the conceptualization of HPV within these plans, and the focus of plans on structural changes to reduce cervical cancer disparities. Data were gathered by systematic content analysis of CCC plans from 50 states and the District of Columbia from February-June 2014 for evidence of cervical cancer prioritization, conceptualization of HPV, and focus on structural barriers to cervical cancer vaccination, screening or treatment. Findings indicate that prioritization of cervical cancer within state CCC plans may not be a strong indicator of state efforts to reduce screening and treatment disparities. While a majority of plans reflected scientific evidence that HPV causes cervical and other cancers, they did not focus on structural elements impacting access to evidence-based interventions. Opportunities exist to improve state CCC plans by increasing their focus on structural interventions that impact cervical cancer prevention, detection, and treatment, particularly for the 41% of plans ending in 2015 and the 31% ending between 2016 and 2020. Future studies should focus on the use of policy tools in state CCC plans and their application to cervical cancer prevention and treatment.
authors.affiliation: Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Indiana University-Purdue University Indianapolis (IUPUI) Center for HPV Research, Indianapolis, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana. bmeyerso@indiana.edu.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Meyerson
authors.affiliation: Indiana University-Purdue University Indianapolis (IUPUI) Center for HPV Research, Indianapolis, Indiana. Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
authors.affiliation: Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana.
authors.forename: Gurprit S
authors.initials: GS
authors.lastname: Multani
authors.affiliation: Indiana Cancer Consortium, Indianapolis, Indiana.
authors.forename: Caleb
authors.initials: C
authors.lastname: Levell
authors.affiliation: Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Lawrence
authors.affiliation: Indiana Cancer Consortium, Indianapolis, Indiana. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control; D011634:Public Health / Q000379:methods*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology