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. 2023 May 31;23(1):293.
doi: 10.1186/s12905-023-02414-z.

"Day or night, no matter what, I will go": Women's perspectives on challenges with follow-up care after cervical cancer screening in Iquitos, Peru: a qualitative study

Rachel M Morse  1 , Magdalena Jurczuk  1 , Joanna Brown  2 , Lita E Carrillo Jara  3 , Graciela Meza  4 , E Jennifer Ríos López  2 , J Kathleen Tracy  5 , Patti E Gravitt #  5 , Valerie A Paz-Soldan #  6   7   8 ; Proyecto Precancer Study Group
Collaborators, Affiliations

"Day or night, no matter what, I will go": Women's perspectives on challenges with follow-up care after cervical cancer screening in Iquitos, Peru: a qualitative study

Rachel M Morse et al. BMC Womens Health. .

Abstract

Background: The study's objective was to explore the factors associated with loss to follow-up among women with abnormal cervical cancer screening results in Iquitos, Peru from women's perspectives.

Methods: In-depth interviews were conducted with 20 screen-positive women who were referred for follow-up care but for whom evidence of follow-up was not found. Interview transcripts were thematically analyzed inductively, and the codes were then categorized using the Health Care Access Barriers Model for presentation of results.

Results: All interviewed women were highly motivated to complete the continuum of care but faced numerous barriers along the way, including cognitive barriers such as a lack of knowledge about cervical cancer and poor communication from health professionals regarding the process, structural barriers such as challenges with scheduling appointments and unavailability of providers, and financial barriers including out-of-pocket payments and costs related to travel or missing days of work. With no information system tracking the continuum of care, we found fragmentation between primary and hospital-level care, and often, registration of women's follow-up care was missing altogether, preventing women from being able to receive proper care and providers from ensuring that women receive care and treatment as needed.

Conclusions: The challenges elucidated demonstrate the complexity of implementing a successful cervical cancer prevention program and indicate a need for any such program to consider the perspectives of women to improve follow-up after a positive screening test.

Keywords: Cervical Cancer; Lost to follow-up; Screening.

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Conflict of interest statement

Patti E. Gravitt reports receiving other commercial research support from Cepheid. No potential conflicts of interest were disclosed by the other authors.

Figures

Fig. 1
Fig. 1
The Screening and Treatment Continuum of Care. Note. a depicts the screening and treatment continuum of care according to the MINSA’s national plan for prevention and control of cervical cancer 2017–2021. b shows how the MRIS network has adapted the MINSA plan in accordance with existing resources (in blue)
Fig. 2
Fig. 2
Where women were lost-to-follow-up or completed care in the continuum of care. Note. The yellow boxes depict the steps in the continuum of care while the red boxes show how many women dropped out a given step, and the blue boxes show how many women completed care at a particular step in the continuum of care
See this image and copyright information in PMC

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