{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:08:03Z","timestamp":1784714883248,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>The U.S.-affiliated Pacific Islands (USAPI) have higher cervical cancer incidence and mortality rates and lower screening coverage compared with the United States. This is likely because of economic, geographical, health care delivery, and cultural barriers for women living in these resource\u2010constrained, isolated regions. The most recent U.S. and World Health Organization cervical cancer screening guidelines recommended primary human papillomavirus (HPV) testing as one screening option or the preferred screening modality. Primary HPV screening-based strategies offer several advantages over current screening methods in the USAPI. However, adoption of this newer screening modality has been slow in the United States and not yet incorporated into USAPI screening programs. The U.S. Centers for Disease Control and Prevention and partners initiated the Pacific Against Cervical Cancer (PACe) project in 2019 to evaluate the feasibility, acceptability, and cost\u2010effectiveness of primary HPV testing-based strategies in Guam and in Yap, Federated States of Micronesia. This report provides an overview of the PACe project and outlines the approaches we took in implementing primary HPV testing as a new cervical cancer screening strategy (including the option of self-sampling in Yap), encompassing four core components: (1) community engagement and education, (2) medical and laboratory capacity building, (3) health information and system improvement, and (4) modeling and cost-effectiveness analysis. The PACe project provides examples of systematic implementation and resource appropriate technologies to the USAPI, with broader implications for never screened and under-screened populations in the United States and Pacific as they face similar barriers to accessing cervical cancer screening services.<\/jats:p>","DOI":"10.1089\/jwh.2024.0284","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T05:27:57Z","timestamp":1718170077000},"page":"839-847","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Building Capacity for Cervical Cancer Prevention in U.S.-Affiliated Pacific Islands: The Pacific Against Cervical Cancer Project"],"prefix":"10.1177","volume":"33","author":[{"given":"Jin","family":"Qin","sequence":"first","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Scarinci","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enriquito","family":"Lu","sequence":"additional","affiliation":[{"name":"Family Planning and Reproductive Health Unit, Jhpiego, Johns Hopkins University, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Senkomago","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diep Thi","family":"Ngoc Nguyen","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Abonales","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai\u2019i, Honolulu, Hawaii, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal","family":"Soin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai\u2019i, Honolulu, Hawaii, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Edilyong","sequence":"additional","affiliation":[{"name":"Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Reichhardt","sequence":"additional","affiliation":[{"name":"Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Marfel","sequence":"additional","affiliation":[{"name":"Yap State Department of Health Services, Colonia, Micronesia (the Federated States of)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Simms","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Canfell","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, a joint venture between Cancer Council New South Wales and the University of Sydney, Sydney, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Saraiya","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Palafox","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai\u2019i, Honolulu, Hawaii, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"Pacific Regional Central Cancer Registry. (2023) Cancer in the U.S. affiliated pacific islands 2007\u20132020 University of Hawai\u2019i online. Available from: https:\/\/pacificcancer.org\/_docs\/pij-cancer-facts-figures-2007-2020-final-to-share_smallfile.pdf"},{"key":"e_1_3_7_3_2","unstructured":"U.S. Cancer Statistics Working Group. U.S. cancer statistics data visualizations tool based on 2022 submission data (1999-2020): U.S. department of health and human services Centers for Disease Control and Prevention and National Cancer Institute. Available from: https:\/\/www.cdc.gov\/cancer\/dataviz [Last accessed: June 2023]."},{"key":"e_1_3_7_4_2","unstructured":"PIHOA NCD Hybrid Survey Reports. Available from: https:\/\/www.pihoa.org\/regional-initiatives\/health-information-management-systems-surveillance-2\/usapi-ncd-surveillance-data\/ [Last accessed: March6 2024]."},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2023.102371"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000161"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2021.22.5.1451"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2013-0340"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.10897"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21628"},{"key":"e_1_3_7_11_2","unstructured":"ACOG Practice Advisory. Updated cervical cancer screening guidelines. 2021. Available from: https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-advisory\/articles\/2021\/04\/updated-cervical-cancer-screening-guidelines [Last accessed: August18 2021]."},{"key":"e_1_3_7_12_2","unstructured":"WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention second edition. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"e_1_3_7_13_2","unstructured":"World Health Organization. Cervical cancer elimination initiative. Available from: https:\/\/www.who.int\/initiatives\/cervical-cancer-elimination-initiative#cms [Last accessed: Dec17 2023]."},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-18-0419"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000453"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106358"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-20-1673"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-007380"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00271-6"},{"key":"e_1_3_7_20_2","first-page":"267","volume-title":"Health Issues in the Black Community","author":"Airhihenbuwa C","year":"1992","unstructured":"Airhihenbuwa C. Health promotion and disease prevention strategies for African Americans: A conceptual model. In: Braithwaite RLTS, , Treadwell HM. Eds. Health Issues in the Black Community. Jossey-Bass Publishers: San Francisco, CA; 1992; pp. 267-280."},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-010-0737-x"},{"key":"e_1_3_7_22_2","first-page":"39","volume-title":"Health Behavior and Health Education: Theory, Research, and Practice","author":"Rosenstock I","year":"1990","unstructured":"Rosenstock I. The health belief model: Explaining health behavior through expectancies. In: Glanz KLF, , Rimer BK. Eds. Health Behavior and Health Education: Theory, Research, and Practice. Jossey-Bass Publishers: San Francisco, CA; 1990; pp. 39\u201361."},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/109019817400200405"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1524839910366416"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2016.0162"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.18865\/ed.28.1.11"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dax058"},{"key":"e_1_3_7_28_2","volume-title":"Learning to listen, learning to teach: The power of dialogue in educating adults","author":"Vella J","year":"2002","unstructured":"Vella J. Learning to listen, learning to teach: The power of dialogue in educating adults. Jossey-Bass: San Francisco, CA; 2002."},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1353\/cpr.2018.0026"},{"key":"e_1_3_7_30_2","unstructured":"FSM NCCCP. Federated States of Micronesia comprehensive cancer control plan 2019\u20132024. 2019. Available from: https:\/\/ftp.cdc.gov\/pub\/publications\/cancer\/ccc\/fsm_ccc_plan-508.pdf"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000788"},{"key":"e_1_3_7_33_2","unstructured":"Improving data for decision-making: A toolkit for cervical cancer prevention and control programmes. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Available from: https:\/\/cdn.who.int\/media\/docs\/default-source\/ncds\/ncd-surveillance\/cxca\/idccp-toolkit-introduction.pdf?sfvrsn=60f16b08_2 [Last accessed: January8 2024]."},{"key":"e_1_3_7_34_2","unstructured":"Australian Centre for the Prevention of Cervical Cancer. Digital Health\u2014canSCREEN. Available from: https:\/\/acpcc.org.au\/services\/digital-health\/ [Last accessed: Dec17 2023]."},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30157-4"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30007-5"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02600-4"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02601-3"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1010539511410867"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.29392\/joghr.2.e2018016"},{"key":"e_1_3_7_41_2","unstructured":"American Cancer Society Statement. FDA Approval of HPVSelf-Collection for Cervical Cancer Screening. 2021. Available from: https:\/\/pressroom.cancer.org\/releases?item=1325#assets_20295_1325-117 [Last accessed: May15 2024]."}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2024.0284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2024.0284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2024.0284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:26:03Z","timestamp":1782973563000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2024.0284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,12]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1089\/jwh.2024.0284"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2024.0284","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,12]]}}}