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Posted: January 16th, 2024

Exploring Barriers to Primary Care Provider Adherence to Cervical Cancer Screening Guidelines

Exploring Barriers to Primary Care Provider Adherence to Cervical Cancer Screening Guidelines

Cervical cancer is a preventable and treatable disease that affects millions of women worldwide. According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer among women, with an estimated 604,000 new cases and 342,000 deaths in 2020 . The majority of cervical cancer cases and deaths occur in low- and middle-income countries, where access to screening and treatment is limited .

Screening for cervical cancer can detect precancerous lesions and early-stage cancers, which can be treated effectively and reduce mortality. The WHO recommends that all women aged 30-49 years should be screened for cervical cancer at least once in their lifetime, using either a Pap smear, a human papillomavirus (HPV) test, or a visual inspection with acetic acid (VIA) . However, the implementation and uptake of these screening methods vary widely across different regions and settings, depending on the availability of resources, infrastructure, and trained personnel .

Primary care providers (PCPs) play a crucial role in promoting and providing cervical cancer screening to women in their communities. PCPs are often the first point of contact for women seeking health care, and they have the opportunity to educate, counsel, and refer women for screening. However, many PCPs face barriers to adhering to the cervical cancer screening guidelines, such as lack of knowledge, skills, equipment, time, incentives, or support from the health system .

This blog post aims to explore some of the common barriers that PCPs encounter when providing cervical cancer screening services, and to suggest some possible solutions to overcome them.

Lack of knowledge and skills

One of the main barriers that PCPs face is the lack of adequate knowledge and skills on cervical cancer screening. Many PCPs are not familiar with the current screening guidelines, the different screening methods, or the management of abnormal results . Some PCPs may also have misconceptions or myths about cervical cancer screening, such as believing that it is not necessary for women who are not sexually active, who have had a hysterectomy, or who have been vaccinated against HPV .

To address this barrier, PCPs need to receive regular training and updates on cervical cancer screening, including the indications, benefits, risks, limitations, and follow-up of each screening method. PCPs also need to have access to reliable sources of information and guidelines on cervical cancer screening, such as online platforms, mobile applications, or printed materials. Additionally, PCPs need to be able to communicate effectively with women about cervical cancer screening, using clear, simple, and culturally appropriate language .

Lack of equipment and supplies

Another barrier that PCPs face is the lack of adequate equipment and supplies for cervical cancer screening. Many PCPs do not have access to the necessary tools and materials for performing Pap smears, HPV tests, or VIA . For example, some PCPs may not have enough speculums, spatulas, slides, fixatives, transport media, or laboratory facilities for Pap smears. Similarly, some PCPs may not have enough HPV test kits or devices for VIA . These shortages can lead to delays in screening or reporting of results, which can affect the quality and effectiveness of the screening program.

To address this barrier, PCPs need to have sufficient and consistent supply of equipment and materials for cervical cancer screening. This requires adequate planning, budgeting,
procurement,
distribution,
and
monitoring
of
the
screening
resources
by
the
health
system
.
PCPs
also
need
to
have
proper
storage,
maintenance,
and
disposal
of
the
screening
equipment
and
materials,
to
ensure
their
quality
and
safety
.

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