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Cervical Cancer
The Peru Cervical Cancer Prevention Study (PERCAPS): Community-Based Participatory Research in Manchay, Peru
  1. Kimberly L. Levinson, MD, MPH*,
  2. Carolina Abuelo, MD, MSc†,
  3. Eunice Chyung, BS‡,
  4. Jorge Salmeron, MD, ScD§,
  5. Suzanne E. Belinson, MPH, PhD∥,
  6. Carlos Vallejos Sologuren, MD,
  7. Carlos Santos Ortiz, MD,
  8. Maria Jose Vallejos, MBA and
  9. Jerome L. Belinson, MD∥,#
  1. *The Cleveland Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cleveland, OH;
  2. †PRISMA, JohnsHopkins Hospital, NIH, Fogarty Fellow in Infectious Disease,Baltimore, MD;
  3. ‡Case Western Reserve School of Medicine, Cleveland, OH;
  4. §Instituto Mexicano del Seguro Social, Cuernavaca Morelos, Mexico;
  5. ∥Preventive Oncology International, Cleveland, OH;
  6. Division de Investigacion-Oncosalud, Lima, Peru; and
  7. #Cleveland Clinic Lerner College of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cleveland, OH.
  1. Address correspondence and reprint requests to Kimberly L. Levinson, MD, MPH, 9500 Euclid Ave A81, Cleveland, OH 44195. Email: levinsk{at}ccf.org.

Abstract

Objective Cervical cancer is a preventable disease which causes significant morbidity and mortality, particularly in developing countries. Although technology for early detection continues to improve, prevention programs suffer from significant barriers. Community-based participatory research is an approach to research which focuses on collaboration with the community to surmount these barriers. The objective of this study was to evaluate the utility of community-based participatory research techniques in a mother-child screen/treat and vaccinate program for cervical cancer prevention in Manchay, Peru.

Materials and Methods Human papillomavirus (HPV) self-sampling and cryotherapy were used for the screen/treat intervention, and the Gardasil vaccine was used for the vaccine intervention. Community health workers from Manchay participated in a 3-day educational course, designed by the research team. The community health workers then decided how to implement the interventions in their community. The success of the program was measured by (1) the ability of the community health workers to determine an implementation plan, (2) the successful use of research forms provided, (3) participation and retention rates, and (4) satisfaction of the participants.

Results (1) The community health workers used a door-to-door approach through which participants were successfully registered and both interventions were successfully carried out; (2) registration forms, consent forms, and result forms were used correctly with minimal error; (3) screen/treat intervention: 97% of registered participants gave an HPV sample, 94% of HPV-positive women were treated, and 90% returned for 6-month follow-up; vaccine intervention: 95% of registered girls received the first vaccine, 97% of those received the second vaccine, and 93% the third; (4) 96% of participants in the screen/treat intervention reported high satisfaction.

Conclusions Community-based participatory research techniques successfully helped to implement a screen/treat and vaccinate cervical cancer prevention program in Manchay, Peru. These techniques may help overcome barriers to large-scale preventive health-care interventions.

  • Cervical cancer
  • Prevention
  • Community-based participatory research

https://doi.org/10.1097/IGC.0b013e318275b007

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    Footnotes

    • Supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, National Eye Institute, National Heart, Blood, and Lung Institute, National Institute of Dental and Craniofacial Research, National Institute on Drug Abuse, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Office of Women’s Health and Research through the Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University (R24 TW007988) and the American Relief and Recovery Act; Preventive Oncology International; and in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc.

    • The authors declare no conflict of interest.