Abstract PR05: Cancer screening uptake among women in substance abuse treatment
Authors: Felini Martha J. , Qualls-Hampton Raquel , Bangara Saritha , Taylor Darius , Voskuhl Gene W. 
Published: October 2015

Purpose: Women in residential and out-patient substance abuse treatment programs represent a broad range of criminally affected indigent women and vulnerable street sex workers at highest risk of cervical cancer. This population is underrepresented in research, but through a nontraditional partnership with law enforcement this project capitalized on reaching a previously hard to reach population that is at high risk for cervical cancer and more likely to not have participated in recommended cervical screens. Scientific studies describe female jail populations receptive to cervical screenings with approximately 70-90% reporting a Pap screen in the last three years; however, knowledge of screening for cancer was poor. Preliminary findings from focus groups conducted among the target population suggest that self-administered HPV testing would not be well accepted or trusted among this population. Thus, the purpose of this study was to evaluate the uptake rate of cervical cancer screening from female nurse practitioners.

Methods: Using findings from preliminary focus groups conducted among the target population, investigators adapted and integrated an evidence-based, culturally appropriate, and trauma sensitive women's health education into the largest female substance abuse center in Dallas, Texas, to prepare women for the opportunity to participate in a cervical exam the following day. Cervical screenings were provided at the AIDS Arms outpatient clinic which specializes in providing medical care to extremely poor and vulnerable populations. Other screenings provided included anal, breast, HIV/ sexually transmitted infections, and Hepatitis B and C. Screening positives are navigated by care coordinators for diagnostic screening.

Results: Over a five month period, 214 women in residential substance abuse treatment have completed the education seminar on cancer prevention and screening. One third of those participating were African American, Hispanic, or American Indian. Over 98% of women completing education seminar signed up for the cancer screening opportunity and completed the screening the next day. Approximately 5% of cervical pap smear results received thus far were abnormal (ASCUS or LSIL). Nearly 15% reported last pap smear 5 - 10 years ago. One out of every four tested positive for anal high risk HPV.

Conclusion: The uptake rate observed in this population exceeded what was anticipated based on the few studies of jail populations available. Thus, women in substance abuse treatment present an exceptional window of opportunity to engage them in cancer screening programs. We hypothesize that trauma-based education prior to offering a cervical exam is a critical factor in increasing screening uptake among this population.

Three year project funded by Cancer Prevention Research Institute of Texas. Screening is ongoing through 2016.

This abstract was also presented as Poster B71.

Citation Format: Martha J. Felini, Raquel Qualls-Hampton, Saritha Bangara, Darius Taylor, Gene W. Voskuhl. Cancer screening uptake among women in substance abuse treatment. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr PR05.