ArticleBMC public health2024
Challenges associated with follow-up care after implementation of an HPV screen-and-treat program with ablative therapy for cervical cancer prevention.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- New cheaper human papilloma virus mass screening strategy reduces cervical cancer incidence in Changsha city: A clinical trial.World journal of clinical oncology · 2024Trial
- Delivering cervical cancer screening and management to women in remote communities of the Peruvian Amazon: a mixed methods analysis of a mobile point-of-care intervention.Lancet regional health. Americas · 2026Article
- Barriers and facilitators of adherence to cervical cancer screening follow-up among women living with HIV in South Ethiopia: a qualitative study.BMC primary care · 2026Article
- Adherence to HPV-Based Cervical Cancer Screening: A Concept Analysis for Nursing and Midwifery Practice.Journal of multidisciplinary healthcare · 2026Review
- Long-term risk and predictors of high-risk human papillomavirus persistence after thermal ablation amongst women living with HIV in West Africa.HIV medicine · 2025Article
- Evaluation of an intelligent digital platform for population management in cervical cancer screening.Cancer biology & medicine · 2025Observational
- "The problem is not detection, it is treatment": exploring why women needing pre-cervical cancer care are lost to follow-up at the hospital in Iquitos, Peru.BMC health services research · 2025Article
- A mixed-methods preliminary evaluation of an innovative treatment for cervical precancer in El Salvador's screen-and-treat program.BMC women's health · 2025Article
- Healthcare Providers' Perspectives Regarding Barriers and Facilitators to Former Pap/VIA-Based Screen-and-Treat Program in Iquitos, Peru.Global implementation research and applications · 2025Article
- A realist evaluation of a novel cervical cancer prevention strategy in Iquitos, Peru.PLOS global public health · 2025Article
- Implementation of new technologies designed to improve cervical cancer screening and completion of care in low-resource settings: a case study from the Proyecto Precancer.Implementation science communications · 2024Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundCervical cancer is a preventable cancer; however, decreasing its prevalence requires early detection and treatment strategies that reduce rates of loss to follow-up. This study explores factors associated with loss to follow-up among HPV-positive women after implementation of a new HPV-based screen-and-treat approach for cervical cancer prevention in Iquitos, Peru.
methodsWe conducted semi-structured interviews with "obstetras" (i.e., midwives) (n = 15) working in cervical cancer prevention and women (n = 24) who were recorded as lost to follow-up after positive HPV results. We used the Health Care Access Barriers Model to guide analyses. We utilized manifest content analysis to describe barriers to follow-up according to the obstetras and thematic analysis to report themes from the women's perspectives. We also report the steps and time taken to contact women.
resultsWe found an incomplete and fragmented patient monitoring system. This incomplete system, in conjunction with challenges in contacting some of the women, led to structural barriers for the obstetras when attempting to deliver positive results. Women in this study expressed a desire to receive treatment, however, faced cognitive barriers including a lack of understanding about HPV results and treatment procedures, fear or anxiety about HPV or treatment, and confusion about the follow-up process. Women also reported having important work matters as a barrier and reported frequently using natural medicine. Reported financial barriers were minimal.
conclusionThis study highlights the barriers to follow-up after implementation of a primary-level HPV-based screen-and-treat approach. While some barriers that have previously been associated with loss to follow-up were not as prominently observed in this study (e.g., financial), we emphasize the need for screen-and-treat programs to focus on strategies that can address incomplete registry systems, structural challenges in results delivery, cognitive barriers in understanding results and treatment, and work-related barriers.
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