U of M Medical School earns $2.9M to reduce cervical cancer screening disparities in Somali women

The research team aims to develop a self-sampling method to be deployed in primary care settings

MINNEAPOLIS/ST. PAUL (08/25/2021) — A new study led by the University of Minnesota Medical School and the University of Washington School of Public Health looks to solve cervical cancer disparities among Somali women. The National Cancer Institute awarded the team with $2.9 million to increase the number of cervical cancer screenings for that population by developing a self-sampling method. 

“Somali women living in the U.S. have lower cervical cancer screening rates than the U.S. general female population,” said Rebekah Pratt, PhD, an assistant professor in the Department of Family Medicine and Community Health and co-lead investigator of the trial along with Rachel Winer, PhD, at University of Washington School of Public Health.

“This disparity is due to a range of factors, including limited awareness of human papillomavirus (HPV) and cervical cancer, cultural and religious beliefs, mistrust of healthcare providers and concerns around modesty. HPV self-sampling is an emerging cervical cancer screening modality that may address common screening barriers among Somali women, particularly those related to modesty,” Pratt said.

Research shows that HPV self-sampling is accurate for detecting precancerous cervical lesions and is effective in reaching under-screened women. While that research has focused primarily on home-based HPV self-sampling, Pratt says there is an untapped opportunity to offer HPV self-sampling in the primary care setting. 

In their study, Pratt and Winer’s team will conduct focus groups with Somali patients and interviews with providers to identify current barriers to care and develop a culturally-appropriate self-sampling intervention. Then, the team will introduce that intervention at two primary care clinics, where the team will study whether or not cervical cancer screenings increase year after year compared to 27 control clinics where the intervention is not available.

“A science-based analysis of the processes needed to successfully implement the intervention will lead to sustainable, novel strategies to support the integration of HPV self-sampling into primary care,” Pratt said. “Our hypothesis is that by integrating it into primary care, we will see an increased uptake of cervical cancer screenings for Somali women, which can lead to better health outcomes. These findings could help clinics use HPV self-sampling as a strategy to increase cervical cancer screening for many different under-screened groups.”

Along with Pratt and Winer, collaborators on the study include Rahel Ghebre, MD, MPH, Timothy Ramer, MD, and Sophia Yohe, MD, from the University of Minnesota Medical School, and Bryan Weiner, PhD, and Adam Szpiro, PhD, from the University of Washington.

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