{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:56:57Z","timestamp":1790607417635,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The World Health Organization (WHO) 90\u201170\u201190 cervical cancer elimination targets aim for 90% human papillomavirus (HPV) vaccination rates, 70% cervical screening rates, and 90% treatment rates for women with cervical disease. Although progress has been made in vaccination and screening in South Africa, less is known about treatment coverage following abnormal screening results. We focused on adherence to colposcopy clinic referrals among women with abnormal cytology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective descriptive study of cervical cytology samples collected in 2022 from women attending 19 public healthcare facilities within a sub\u2011district of Cape Town. All cytology results reported as high\u2011grade intraepithelial lesions or invasive cervical carcinoma (HSIL+) were included. Colposcopy clinic attendance was defined as documented histological sampling within 24 months of diagnosis. Colposcopy clinic attendance rates (CCARs), test time intervals, and distance from referral hospital were calculated for each facility. Facilities were compared using percentile distributions, and distance to referral hospitals was analyzed as a potential spatial barrier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 9,069 cervical samples, 556 (6.1%) were reported as HSIL+. Overall, 65.8% of women underwent histological sampling within 24 months. CCARs varied across facilities, ranging from 42.5% to 87.5% (mean 63.1%). Distance to referral hospitals (range 0\u201322\u00a0km; mean 10.8\u00a0km) showed no correlation with colposcopy clinic attendance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A substantial gap exists between current CCARs and the WHO treatment target. Variability among facilities, independent of geographic distance, suggests that health system factors, such as communication, recall, and referral processes, play a key role in treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70360","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:39:41Z","timestamp":1788568781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Pap Test to Treatment: Assessing Facility Level Gaps in Cervical Cancer Care in Cape Town"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8582-0962","authenticated-orcid":false,"given":"Greta Sophie","family":"Neethling","sequence":"first","affiliation":[{"name":"National Health Laboratory Service and Department of Pathology Division of Anatomical Pathology Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2981-4724","authenticated-orcid":false,"given":"Rubina","family":"Razack","sequence":"additional","affiliation":[{"name":"National Health Laboratory Service and Department of Pathology Division of Anatomical Pathology Faculty of Medicine and Health Sciences Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6046-1453","authenticated-orcid":false,"given":"Matthys Hendrik (Hennie)","family":"Botha","sequence":"additional","affiliation":[{"name":"Unit Gynaecological Oncology Department of Obstetrics and Gynaecology Faculty of Medicine and Health Sciences Stellenbosch University and Tygerberg Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization","year":"2020"},{"key":"e_1_2_15_3_1","unstructured":"World Health Organization Cervical Cancer: Fact Sheet(World Health Organization 2025) https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/cervical\u2010cancer."},{"key":"e_1_2_15_4_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J.","year":"2024"},{"key":"e_1_2_15_5_1","volume-title":"Human Papillomavirus and Related Diseases in South Africa","author":"Bruni L.","year":"2023"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.58676\/sjmas.v3i2.108"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101754"},{"key":"e_1_2_15_8_1","unstructured":"W.Jassat \u201cAn Evaluation of the Cervical Screening Programme in Johannesburg Metro District Gauteng Province\u201d (Academic diss. University of the Witwatersrand 2010)."},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.18332\/popmed\/165609"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13485"},{"issue":"4","key":"e_1_2_15_11_1","first-page":"70","article-title":"Audit of Cervical Cancer Screening and Colposcopy Attendance in Rural South Africa","volume":"18","author":"Knegt Y.","year":"2014","journal-title":"African Journal of Reproductive Health"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2015.002469"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.7196\/sajog.388"},{"key":"e_1_2_15_14_1","unstructured":"B. T.Guzha \u201cLong\u2010Term Outcomes of Women Treated for High\u2010Grade Squamous Intraepithelial Lesions at a South African University Colposcopy Unit: A Five\u2010Year Retrospective Cohort Study\u201d (Master's diss. University of Cape Town 2019)."},{"key":"e_1_2_15_15_1","unstructured":"K.MurieandA.De Sa Cervical Screening Programme Audit(2010). Grey Literature."},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2022.07.061"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jth.2024.101819"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70360","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/puh2.70360","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:10:28Z","timestamp":1790604628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/puh2.70360"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70360","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70360"}}