Introduction
The objective of this study is to better understand cervical cancer screening and
follow-up practices in U.S. prisons.
Methods
A 29-question survey examining cervical cancer screening practices, education, and
facility/patient characteristics was disseminated to state-prison medical directors.
Results
A total of 70% (35/50) of state medical directors completed the survey between August
2021 and January 2022. All prison systems provided cervical cancer screening both
at intake and specified intervals. A total of 36% provided colposcopy on site, and
9% performed excisional procedures on site. A total of 11 states identified 1‒5 cases
of cervical cancer within the last year. Frequently cited challenges included a perceived
lack of patient interest, delays in community referral, and lack of follow-up of abnormal
results after release.
Conclusions
This study found relatively high rates of screening with a perceived lack of patient
interest as the most reported barrier. Follow-up care was also often affected by reported
lack of patient interest, delays in community referral for diagnostic procedures,
and patient release before follow-up. There is room for further optimization of screening
and surveillance among incarcerated women by understanding and addressing systems-based
challenges. By understanding patient barriers to primary screening, expanding access
to onsite testing and community referral for abnormal results, and streamlining post-release
follow-up, disparities in care among incarcerated women can be reduced.
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
