Cervical Cancer Screening and Follow-Up Practices in US Prisons

Introduction: The objective of this study is to better understand cervical cancer screening and fol-low-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 proce-dures on site. A total of 11 states identified 1-5 cases of cervical cancer within the last year. Fre-quently 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 bar-riers 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.Am J Prev Med 2023;64(2):244-249.(c) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.