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Preventing Cervical Cancer: Stakeholder Attitudes Toward CareHPV-Focused Screening Programs in Roi-et Province, Thailand
  1. Lee A. Trope, BS*,
  2. Bandit Chumworathayi, MD and
  3. Paul D. Blumenthal, MD, MPH
  1. *Program in Science, Technology and Society, Stanford University, Stanford, CA,
  2. Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Khon Kaen University, Khon Kaen, Thailand, and
  3. Division of Gynecologic Specialties, Department of Obstetrics and Gynecology, Stanford School of Medicine, Stanford University, Stanford, CA.
  1. Address correspondence and reprint requests to Lee A. Trope, BS, Program in Science, Technology and Society, Stanford University, 300 Pasteur Drive HH-333, Stanford, CA 94305-5317. E-mail: lat008{at}stanfordalumni.org.

Abstract

Objective: To assess which of the 5 CareHPV-inclusive protocols stakeholders in Roi-et Province, Thailand found (1) most preferable and (2) most beneficial to the overall goal of reducing cervical cancer.

Design: Five CareHPV-inclusive cancer prevention approaches were presented to a convenience sample of colposcopists, trainers, health care providers, district medical directors, and district health officers. Participants ranked their preference for each plan (A-E) compared with the current screening protocol and also the perceived comparative benefit of the plans. Plans differed in whether every patient was screened using both the human papillomavirus (HPV) test and visual inspection with acetic acid (VIA) or only HPV-positive women were screened with VIA; in clinician versus self-swab and in hospital/clinic-based or village-based screening.

Results: Overall, participants supported an innovative plan in which women would be screened in their homes and villages using the self-swab version of the CareHPV DNA test, and only those who screened positive for HPV are screened with VIA. When results were stratified by provider type (physician vs nonphysician) and/or practice concentration (hospital-oriented vs field-oriented), preference and perceived benefit for the plans differed significantly with physician/hospital-oriented participants and are more likely to be skeptical of the self-swab version of the CareHPV test.

Conclusions: Providers in Thailand recognize the potential value of a rapid HPV test as part of a cervical cancer prevention program and, overall, support a patient-administered self-swab followed by visual confirmation and treatment as the most practical CareHPV-inclusive approach largely because of the likely increase in coverage. Future studies will further define the clinical benefits and limitations of this test.

  • Cervical cancer screening
  • HPV DNA
  • Technology
  • VIA

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