PRP165: Sustainable Partnership for Cervical Cancer Screening in Rural Guatemala
Context: Cervical cancer, though preventable and treatable, kills hundreds of thousands of women every year, the vast majority in low- and middle-income countries. Guatemala, a Central American, middle-income country with significant healthcare inequity, struggles with high rates of cervical cancer. Our 2019 mixed-methods survey in San Lucas Tolimán (SLT), Guatemala, a largely indigenous, rural municipality, shows that 97% of women express interest in cervical cancer screening, but the vast majority cannot access screening or reliable follow-up. While 90% of women interviewed had heard of cervical cancer, only 51% had ever received a Pap smear. In this municipality, several women who had been able to access screening were diagnosed with cancer or precancerous lesions, but were unable to complete treatment due to financial, cultural, or logistical barriers. Thus, SLT is well-positioned for a collaborative global health intervention around cervical cancer screening and treatment. Objective: Scale culturally appropriate and high-quality cervical cancer screening and treatment, centering local healthcare workers and community outreach to ensure equity and sustainability. Study design: Community-based participatory research, mixed-methods program evaluation. Population studied: Women ages 18-65 in SLT municipality served by local community health workers. Intervention/Instrument: PCR-based HPV self-swab testing, CommCare mobile health platform for case management, and wrap-around services and interprofessional networking facilitating follow-up testing and treatment. Outcome measures: Percentage of eligible women screened and successful referrals for follow-up testing and treatment; qualitative analysis of patient and promoter satisfaction and residual barriers to testing and treatment. Expected results:. We anticipate that this program will significantly increase the percentage of eligible women who complete the continuum of cervical cancer care from screening to treatment. Preliminary conclusions: Our project will integrate US providers, local Guatemalan health professionals, and Guatemalan governmental cancer experts to form scalable and accessible screening and follow-up strategies. We will build a best practices toolkit to allow healthcare professionals in areas with similar resource limitations to scale our approach for sustainable, community-driven cervical cancer prevention and treatment.