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Cervical Cancer Education and Prevention Project - Phase II
Sharon M. Bond, CNM, MSN, CS
College of Nursing

  Specific Aims:
  • Provide care for women with abnormal Pap tests
  • Establish sites for interdisciplinary student learning
  • Determine predictors of Cervical Intraepithelial Neoplasia
  • Evaluate cost-effectiveness of care
 
In South Carolina, the rates of new case of and deaths from cervical cancer are among the highest in the United States. To test the possibility that the high rates may be related to too few screening tests, the South Carolina Department of Health and Environmental Control provides Pap testing through its family planning clinics. Once tested, however, about half the women with abnormal results do not get follow-up care. This project provided a variety of clinical services to women with minor Pap test abnormalities, the choice of services based on an inexpensive but reliable assessment tool. Urban and rural, low income, mainly African-American women, 14 to 45 years old, were identified for this project through their mildly abnormal Pap test results. Patients in Charleston, Berkeley, and Dorchester Counties were followed for two years to determine what combination of services best predicted the level of abnormality of cervical cells and the progression to cancer. Students from MUSC Colleges of Nursing and Medicine had the opportunity to learn about women's health at these sites. Data on the service combinations was used to determine a cost-effective model of care for women with mildly abnormal cervical cells that could be used throughout the State, with funding from the Department of Defense.

  Results:
  • Over 300 women were evaluated for abnormal cytology
  • Approximately 35 medical and nursing students attended outlying clinics, seeing patients and participating in the study
  • Determine predictors of Cervical Intraepithelial Neoplasia
  • The study indicates patients with a high risk HPV DNA type are more likely to progress to HGSIL (relative risk of at least 8).
  • The study described and tested a model that, with some modifications, can work to provide cost effective care to follow-up services in the evaluation and monitoring of minor Pap smear abnormalities, among low income women without health insurance utilizing SCDHEC clinics.
 

Sharon M. Bond, CNM, MSN, CS, is continuing her research through the funding from the Department of Defense. You may obtain further information regarding her work with Cervical Cancer Education by e-mail her at bondsm@musc.edu.



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