Fox Chase Receives Research Funding for Cervical Cancer Screening Disparities Among Asian Americans

In an effort to promote cervical cancer screening in the Asian American community, Fox Chase Cancer Center plans to launch the first large scale study evaluating a new screening method that allows self-collection of samples, which are later tested by a lab for human papillomavirus (HPV). To carry out this study, Fox Chase was awarded a $3.1 million grant from the National Cancer Institute.¹

The importance of this study may be found in statistics from the Centers for Disease Control (CDC) and Prevention, which show that HPV is the most common sexually transmitted infection in the United States. Of the 5 types of cancer that can develop as a result of HPV in women, CDC data from 2019 shows that cervical cancer has the highest number of cases. Specifically, 10,900 women developed cervical cancer from HPV in 2019 compared with anal cancer (4200), vulvar cancer (2800), back of throat cancer (2200), and vaginal cancer (600).²

“Cervical cancer screening rates are suboptimal among Asian American women, despite considerable efforts to improve Pap test screening,” said Carolyn Y. Fang, PhD, a principal study investigator and co-leader of the Cancer Prevention and Control Research Program at Fox Chase.

The most recent data from the National Health Interview Survey conducted by the CDC on cancer screening among Asian subgroups also reveals that these patients have barriers to cancer screening use, which may be impacted by multiple factors, including the region of origin and length of residency in the United States.

“Many of the barriers to screening reported by this population are ones that cannot be easily remedied with traditional health promotion programs. Thus, we sought to explore novel approaches for increasing participation in cervical cancer screening,” Fang said.

Data from 2008, 2010, and 2013, showed that Asian women had lower pap test use (71.7%) than Caucasian women (83.2%, P <.001), African American women (84.3%, P <.001), and indigenous Americans (81.2%, P =.002). Of the small population of Asian women who did receive pap tests, the majority identified as Filipino (82.7%, 95% CI, 78/0%-86.7%), whereas Indian (66.8%, 95% CI, 60.9%-72.2%), Chinese (68.7%, 95% CI 62.5%-747.4%) , and other Asian groups (68.1%, 95% CI, 63.6%-72.2%), were less likely to get pap tests.³

In terms of time in the United States, Asian women who had been in the country for 10 years or more had higher pap test rates than others. Recent immigrants had the lowest percentage of pap tests.

The Cancer Prevention and Control Research Program at Fox Chase and the Center for Asian Health and Associate Dean for Health Disparities at the Temple University Lewis Katz School of Medicine will collaborate to conduct this research with both Fang and Grace X. Ma. PhD, of Lewis Katz School of Medicine, leading the project.¹

The study will examine self-obtained samples from 800 Asian women a community sites which will be compared pap smear test at gynecologic clinics. This will be the first study to explore self-collection in Asian American women, as prior research has predominantly focused on other racial groups.

Dr. Ma stated, “the utilization of this innovative HPV self-sampling tool can potentially improve cervical cancer screening among the underserved Asian Americans with limited English proficiency, as well as other minority women in low-resource settings.”

Twelve community sites will be utilized to assess the self-collected samples for HPV testing, and 12 community centers will provide the same sample collection model but with the addition of community education, language assistance, and transportation services.

“This research will inform future health promotion programs for patients who are unable to attend a healthcare facility for clinic-based cervical cancer screening. This work will also allow us to explore whether this approach is a cost-effective strategy, which is valuable information for those policymakers who establish national screening guidelines,” Fang added.

_References:

_{1. Fox Chase researchers receive grant to study approaches for empowering asian american women in cervical cancer screening. News release. Fox Chase Cancer Center. June 22, 2020. Accessed June 24, 2020. https://bit.ly/31btVfZ}

_{2. How Many Cancers Are Linked with HPV Each Year? CDC website. Accessed June 24, 2020. https://bit.ly/31jfRAS}

_{3. Shoemaker ML and White MC. Breast and cervical cancer screening among Asian subgroups in the USA: estimates from the National Health Interview Survey, 2008, 2010, and 2013. Cancer Causes Control. 2016; 27(6): 825–829. doi:10.1007/s10552-016-0750-5}