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. 2023 Jul 24:35:102347.
doi: 10.1016/j.pmedr.2023.102347. eCollection 2023 Oct.

Factors associated with receiving results and attending colposcopy in patients with positive HPV screens in Mexico City

Leith León-Maldonado  1 , Raúl U Hernández-Ramírez  2 , Leticia Torres-Ibarra  1 , Donna Spiegelman  2 , Sangini S Sheth  3 , Eduardo Lazcano  4 , José D Cadena-Fiscal  5 , Jorge Salmerón  6
Affiliations

Factors associated with receiving results and attending colposcopy in patients with positive HPV screens in Mexico City

Leith León-Maldonado et al. Prev Med Rep. .

Abstract

We identified patient and healthcare system factors related to receipt of screening results and attendance to colposcopy among patients with positive screening results in a cervical cancer screening program in Mexico City, Mexico. We analyzed data from 1,351 patients with high-risk human papillomavirus (HPV)-positive results from two screening demonstration studies conducted between 2017 and 2018. Factors associated with receipt of screening results and with adherence to a colposcopy appointment were identified using multivariable logistic regression. Participants had a median age of 40 years (IQR = 32-48), 60% had less than high school education, and 74% had a previous Pap screening in the last 5 years. Fifty-five percent of participants retrieved their screening results at the healthcare facility (HCF) without any reminder. Providing an email address for contact information, attending a HCF with family medicine, and receiving care from experienced nurses were associated with greater adherence to obtaining screening test results. Fifty-seven percent of participants attended their first scheduled colposcopy appointment. Providing a phone number improved adherence to colposcopy, whereas longer travel times between the HCF and the colposcopy clinic was associated with a decrease in colposcopy adherence. Having a Pap test in the last 5 years was positively associated with better compliance with both outcomes. Securing contact information may help to overcome barriers to future follow-up. Additional research is necessary on strategies for obtaining screening test results and scheduling appointments, which may help address barriers to access, such as limited staff availability, distance from the clinic, and travel costs.

Keywords: Abnormal screening results; Barriers; Cervical cancer; Colposcopy; Facilitating factors; Mexico.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of colposcopy follow-up after abnormal screening, FRIDA and FASTER-Tlalpan Study, Mexico City.
See this image and copyright information in PMC

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Further reading

    1. Secretaria de Salud Programa de Acción Específico. Prevención y control del cáncer de la mujer 2013–2018. México: Secretaría de Salud. 2013 Programa sectorial de salud.
    1. Song M, Zhou X, Pazaris M, Spiegelman D. The missing covariate indicator method is nearly valid almost always. Preprint. Posted online October 30, 2021. ArXiv:211100138. doi: 10.48550/arXiv.2111.00138.