{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:44:31Z","timestamp":1782938671125,"version":"3.54.5"},"reference-count":54,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The number of cancer survivors from low- and middle-income countries is rising, but most research has been conducted in high-income countries. Although studies have characterized the detection and treatment of cervical cancer in Botswana, survivorship care is a severely understudied area. We assessed short- and long-term survivorship visit adherence and factors associated with adherence in patients treated for cervical cancer in Botswana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between 2015 and 2022, females with cervical cancer were prospectively enrolled in an observational cohort study. Based on recommendations in the Botswana National Cervical Cancer Guidelines, adherence was defined as completion of a clinical visit biannually (every 6 months) during short-term survivorship care (0-2 years after treatment) and annually for long-term survivorship care (3-5 years after treatment). Generalized estimating equations (adjusted odds ratio [aOR]) were used to evaluate factors associated with short- and long-term adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      This cohort included 857 females treated with definitive- or curative-intent surgery- or radiation-based treatment, with a median age of 47.7 years (IQR, 41.6-58.2 years) and 68.6% living with HIV. On multivariable analysis of short-term care (n = 772), patients who traveled \u2265100 km to the treatment facility (aOR, 0.35;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), had advanced-stage (III and IV) cervical cancer (aOR, 0.69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007), and were undergoing care during the COVID-19 pandemic (aOR, 0.72;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005) were less likely to be adherent. Results were similar for long-term care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Adherence to recommended survivorship visits in Botswana is suboptimal. Strategies to help survivors, particularly those living farther away from treatment facilities and with advanced disease, are needed to improve adherence and reduce cervical cancer mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00352","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:59:24Z","timestamp":1782935964000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to Survivorship Care Visits in Patients With Cervical Cancer in Botswana"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0319-4272","authenticated-orcid":true,"given":"Jessica","family":"George","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6984-9419","authenticated-orcid":true,"given":"Sheldon","family":"Amoo-Mitchual","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3624-9882","authenticated-orcid":true,"given":"Caroline","family":"Kernell","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical School, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawna","family":"Tuli","sequence":"additional","affiliation":[{"name":"Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palak","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barati","family":"Monare","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Kassick","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"},{"name":"Princess Marina Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ketlametswe","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Seiphetlheng","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marata","family":"Tafadzwa","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakim","family":"Sughra","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuraola T. 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