Contributors to cervical cancer disparities in American Indian/ Alaska Native women: Is sufficient research being performed in this population? (572)

Objectives: American Indian/Alaska Native (AIAN) women have 1.5 times the incidence and twice the mortality rate of cervical cancer compared to Non-Hispanic White (NHW) women. This disparity is not limited to cervical cancer but is seen in pap smear screening and HPV vaccination uptake. There appear to be few studies in the literature specific to AI/AN women and the prevention and treatment of cervical cancer. We performed a systematic scoping review to evaluate what is known and what gaps in the literature exist related to cervical cancer and its prevention specific to AI/AN women. Methods: We conducted a systematic scoping review of the literature published between 1990 and 2020 regarding 1) cervical cancer epidemiology (incidence, prevalence, and mortality); 2) cervical cancer screening and prevention (HPV status, HPV vaccine initiation and completion, cervical cancer screening); and 3) cervical cancer diagnoses (presence of cervical dysplasia, and cervical cancer stage) among AI/ANs. Medical Subject Headings (MeSH) terms and key search terms were developed to search PubMed and Scopus databases. Abstracts were separately reviewed and compared; disagreements were discussed, and a consensus was achieved. Data were abstracted for included articles. Results: Our search yielded 515 citations; 146 articles met inclusion criteria and were included in our review. The median impact factor for published articles was 2.14 (0-292). Descriptive studies represented 58.9% of all published articles, followed by observational (23.2%) and interventional studies (11.6%). Cervical cancer screen- ing/dysplasia was the most commonly published topic (50.6%), followed by epidemiologic studies (23.9%), HPV (22.6%), and invasive cancer (2.7%). The Indian Health Service (IHS) regions most heavily represented were the Alaska Area and Great Plains Area (Figure 1). Of the 110 articles in which the funding source was documented, 83.6% were federally funded, 11.8% were funded by a non-profit agency, and the remaining 4.6% were funded by a combination of federal, nonprofit, and/or private industry. Conclusions: AI/AN women continue to experience persistent health disparities related to severe dysplasia and cervical cancer. Our review demonstrates that AI/AN women remain understudied in the literature, with a scant 146 articles published over a 20-year period. We conclude that more resources are needed to be invested in the future to eliminate this preventable cancer in AI/AN women. Objectives: American Indian/Alaska Native (AIAN) women have 1.5 times the incidence and twice the mortality rate of cervical cancer compared to Non-Hispanic White (NHW) women. This disparity is not limited to cervical cancer but is seen in pap smear screening and HPV vaccination uptake. There appear to be few studies in the literature specific to AI/AN women and the prevention and treatment of cervical cancer. We performed a systematic scoping review to evaluate what is known and what gaps in the literature exist related to cervical cancer and its prevention specific to AI/AN women. Methods: We conducted a systematic scoping review of the literature published between 1990 and 2020 regarding 1) cervical cancer epidemiology (incidence, prevalence, and mortality); 2) cervical cancer screening and prevention (HPV status, HPV vaccine initiation and completion, cervical cancer screening); and 3) cervical cancer diagnoses (presence of cervical dysplasia, and cervical cancer stage) among AI/ANs. Medical Subject Headings (MeSH) terms and key search terms were developed to search PubMed and Scopus databases. Abstracts were separately reviewed and compared; disagreements were discussed, and a consensus was achieved. Data were abstracted for included articles. Results: Our search yielded 515 citations; 146 articles met inclusion criteria and were included in our review. The median impact factor for published articles was 2.14 (0-292). Descriptive studies represented 58.9% of all published articles, followed by observational (23.2%) and interventional studies (11.6%). Cervical cancer screen- ing/dysplasia was the most commonly published topic (50.6%), followed by epidemiologic studies (23.9%), HPV (22.6%), and invasive cancer (2.7%). The Indian Health Service (IHS) regions most heavily represented were the Alaska Area and Great Plains Area (Figure 1). Of the 110 articles in which the funding source was documented, 83.6% were federally funded, 11.8% were funded by a non-profit agency, and the remaining 4.6% were funded by a combination of federal, nonprofit, and/or private industry. Conclusions: AI/AN women continue to experience persistent health disparities related to severe dysplasia and cervical cancer. Our review demonstrates that AI/AN women remain understudied in the literature, with a scant 146 articles published over a 20-year period. We conclude that more resources are needed to be invested in the future to eliminate this preventable cancer in AI/AN women.