Female allogeneic hematopoietic cell transplant survivors' perspectives on cervical cancer screening: a retrospective study.
Female allogeneic hematopoietic cell transplantation (AlloHCT) survivors are at increased risk for human papillomavirus (HPV)-related malignancies due to immunosuppression. Guidelines recommend annual cervical cancer screening for AlloHCT survivors with a cervix aged 21-65. This study explored cervical cancer screening knowledge, behaviors, attitudes, experiences, and preferences-specifically provider-collected versus self-collected methods-and identified adherence barriers and facilitators.
We conducted a mixed-methods observational study of female AlloHCT survivors aged 21-65 who received AlloHCT at Oregon Health & Science University between 2012 and 2023. Participants completed demographic surveys and participated in focus groups exploring screening adherence, perceptions, and preferences.
Twenty-three survivors completed the survey, and 16 joined focus groups in fall 2024. The median participant age was 49 years (range 32-61); most were white (87%) and privately insured (91%). Median age at bone marrow transplantation (BMT) was 41 years (range 19-56). Primary diagnosis included acute myeloid leukemia or myelodysplastic syndrome (65%). Reported complications included graft versus host disease (GVHD) (44%), chronic GVHD (39%), and vaginal GVHD (22%). Awareness of increased cervical cancer risk facilitated screening adherence, while limited access to in-network providers was a barrier. All participants preferred provider-collected screening due to confidence in test accuracy and reassurance from clinician involvement. Psychological factors, particularly worrying about recurrence or secondary cancers, strongly influenced screening preferences.
Cervical cancer screening preferences among AlloHCT survivors were shaped by physical and psychological treatment-related factors. HPV self-collection may be a supplemental option before BMT, between annual clinic visits, or when access barriers arise.
We conducted a mixed-methods observational study of female AlloHCT survivors aged 21-65 who received AlloHCT at Oregon Health & Science University between 2012 and 2023. Participants completed demographic surveys and participated in focus groups exploring screening adherence, perceptions, and preferences.
Twenty-three survivors completed the survey, and 16 joined focus groups in fall 2024. The median participant age was 49 years (range 32-61); most were white (87%) and privately insured (91%). Median age at bone marrow transplantation (BMT) was 41 years (range 19-56). Primary diagnosis included acute myeloid leukemia or myelodysplastic syndrome (65%). Reported complications included graft versus host disease (GVHD) (44%), chronic GVHD (39%), and vaginal GVHD (22%). Awareness of increased cervical cancer risk facilitated screening adherence, while limited access to in-network providers was a barrier. All participants preferred provider-collected screening due to confidence in test accuracy and reassurance from clinician involvement. Psychological factors, particularly worrying about recurrence or secondary cancers, strongly influenced screening preferences.
Cervical cancer screening preferences among AlloHCT survivors were shaped by physical and psychological treatment-related factors. HPV self-collection may be a supplemental option before BMT, between annual clinic visits, or when access barriers arise.
Authors
Currier Currier, Van Houweling Van Houweling, Bolten Bolten, Wasson Wasson, Frost-Belansky Frost-Belansky, Woonnimani Woonnimani, Gandhi Gandhi, Bruegl Bruegl
View on Pubmed