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Nearly 70% of all cancer deaths occur in low- and middle-income countries (LMICs) and many of these cancer deaths are preventable. In high-income countries (HICs), patient navigation strategies have been successfully implemented to facilitate the patient's journey at multiple points along the cancer care continuum. The purpose of this scoping review is to understand and describe the scope of patient navigation interventions and services employed in LMICs. A systematic search of published articles was conducted including Medline, Biosis, Embase, Global Health, and Web of Science. Articles were examined for evidence of patient navigation interventions used in cancer care in LMICs. Evidence was synthesized by navigation service provided and by type of outcome. Fourteen studies reported on patient navigation interventions in cancer care in low-income and middle-income countries in Asia, South America, and Africa. Most studies reported on women's cancers and included navigation interventions at most points along the cancer care continuum i.e. awareness, education, screening participation, adherence to treatment and surveillance protocols. Few studies report on cancer patient navigation in LMICs. With the use of an implementation science framework, patient navigation research can explore a broader range of outcomes to better evaluate its potential role in improving cancer control in LMICs.

Background HPV vaccination is highly effective in preventing HPV infection and subsequent precancers and invasive cancers related to HPV. Unfortunately, vaccine coverage in the U.S. lags behind national and global targets. College students are an important audience for catch-up vaccination given suboptimal population coverage in adolescents. This study examined factors associated with college healthcare provider (HCP) practices for routinely screening HPV vaccination history of female college students. Methods One thousand two hundred twenty-one U.S. college HCPs completed surveys and reported on a variety of screening practices in college health centers, including assessing the HPV vaccination status of female college students. Participants included nurse practitioners, physicians, and physician assistants. Results Forty-five percent of college HCPs reported routinely screening the HPV vaccination histories of most (≥ 70%) of their female students. Nurse practitioners (NPs) were more likely than other providers to consistently assess HPV vaccination status. In multivariable logistic regression modeling, high rates of routine HPV vaccination screening were associated with NP role, more positive provider attitudes and self-efficacy toward screening, larger institutions, college-level policies, in-service trainings and electronic health record prompts that supported HPV vaccination history screening. No differences were found by other provider demographic factors, institution type or region. Conclusions College health centers present unique opportunities to identify unvaccinated female students and offer or refer them for vaccination. Future research needs to examine HPV vaccination status and screening among other types of college students and identify the multi-level factors that act as facilitators and barriers to assessing HPV vaccination status and offering the HPV vaccine.

In the United States, vaccination rates for many routinely recommended vaccines have recovered to pre-pandemic levels, yet human papillomavirus (HPV) vaccination rates still lag pre-pandemic levels. This study sought to uncover the potential effects of the pandemic on attitudes about the HPV vaccine, and factors associated with changes in attitudes. We conducted a national survey (n = 3968) of U.S. mothers with children aged 9–17 years. Outcome variables measured changes in attitude toward the HPV vaccine following the pandemic. Two logistic regression models identified predictors of (1) those who did not have attitude changes (always negative vs. always positive), and (2) those who reported attitude changes (change to negative vs. change to positive). Attitudes toward the HPV vaccine remained unchanged in 78.9% of participants (58.1% positive, 20.8% negative). Of the 21.1% reporting changed attitudes, 9.6% changed to positive and 11.5% to negative. Those reporting changing to a negative attitude had a greater odds of reporting conservative political views, and being unsure/undecided about vaccinating their child against HPV compared to those who reported changing to a positive attitude. Targeted strategies are needed to address erosion in confidence in the HPV vaccine and other vaccines resulting from mis- and disinformation associated with the COVID-19 pandemic and future pandemics.

Men aged 27 to 45 are eligible for human papillomavirus (HPV) vaccination as of 2019, yet relatively little is known about whether they have received or intend to receive it. We conducted a cross-sectional, online survey among fathers aged 27 to 45 between March and April 2022, to assess associations between HPV vaccination awareness, behaviors, intentions, and psychosocial constructs from the Health Belief Model. We examined the characteristics of those who had (a) heard of the HPV vaccine, (b) already received ≥ 1 dose, and (c) intentions for future vaccination among those who had never been vaccinated. Among 400 men who completed the survey, 32% were not aware of the HPV vaccine. Among those who were aware, 41% had received ≥ 1 dose. Sixty-three percent of unvaccinated men reported that they intended to get vaccinated in the future. Multivariable logistic regression analyses revealed that age and race/ethnicity were associated with having been vaccinated previously. Among the unvaccinated, multivariable logistic regression analyses revealed that those with a higher perceived risk of HPV-associated cancer had 3.73 greater odds of reporting they would seek vaccination compared to those with lower perceived risk (95% confidence interval [CI] = [1.28, 12.3]). We did not find perceived benefits, barriers, or decision self-efficacy to be related to future vaccine intentions. Since recommendations for this group include shared clinical decision-making, public health efforts should focus on raising awareness of vaccine eligibility, emphasizing risk factors for HPV-associated cancers so that individuals have an accurate perception of risk, and encouraging conversation between men and their providers.

Executive summary Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and health-care professionals, and as cancer researchers and policy makers. In many countries, regardless of geographic region or economic resources, women are more likely than men to lack the knowledge and the power to make informed cancer-related health-care decisions. Ensure data on sex, gender, and other sociodemographic factors are routinely collected in cancer health statistics, publicly reported, and updated. There are important under-examined social implications and economic repercussions for families and societies when individuals experience cancer, in any country, at any age. In many countries, regardless of geographic region or economic resources, women are more likely than men to lack the knowledge and the power to make informed health-care decisions.

Explore mothers of adolescents' use of social media and the influence of social media on hesitancy regarding HPV vaccine. A national online survey of mothers of adolescents aged 9–17 years was conducted in August 2023, with participants recruited from an online research panel of US residents. The study examined socio-demographic factors, social media use patterns, and influence of social media and their association with HPV vaccine hesitancy. Survey sample included 3968 mothers of adolescents. Specifically among the social media variables, multivariable analysis revealed that Facebook influence was negatively associated with HPV vaccine hesitancy (β = −0.016, 95 % confidence interval [CI] = (−0.029, −0.003), p = 0.019), while uncertainty about social media messages (veracity) (β = 0.067, 95 % CI = (0.021, 0.113), p = 0.004) were associated with increased vaccine hesitancy. No significant associations were found with the number of daily-used social media platforms or influence from other platforms. Our findings highlight the impact of uncertainty about social media messages and its effect on parents' HPV vaccine hesitancy. Our findings also highlight the potential role of health care providers in reducing vaccine hesitancy during clinical encounters. Future research is needed to better understand the elements (content, approach, platforms) of effective social media communication interventions to decrease vaccine hesitancy and improve HPV vaccination rates among adolescents in the US. •Social media may influence (positively or negatively) HPV vaccine hesitancy.•Uncertainty about HPV vaccine messaging was associated with HPV vaccine hesitancy.•Providers reduce vaccine hesitancy for those uncertain about vaccine messages.

The Commission report was published in September, 2023, with ten key findings and corresponding priority recommendations directed at a broad range of stakeholder communities: international organisations, national and subnational governments, researchers and research funders, civil society, and the private sector. 1 To increase the likelihood that the recommendations set out in the Commission will be adopted and operationalised by multiple stakeholders, and to support the uptake of these recommendations, the authors proposed a framework and set of key performance indicators to guide implementation and to increase engagement of the global community at the nexus of gender, power, and cancer. [...]the group conducted a desk review of potential indicators and supplemented this review with newly created indicators based on expert consensus, where none existed previously. [...]indicators were prioritised through group discussions based on the existence of baseline data, alignment with agendas, technical feasibility, and relevance to the Commission, and finalised by an anonymous survey to vote on tiers for the indicators (appendix). [...]the modified Delphi process did not include an external review phase, but the Commission is highly interdisciplinary and included external partners in the expert panel.

Cervical cancer is the second leading cause of cancer death for women in the Dominican Republic. Vaccination against human papillomavirus (HPV) could reduce mortality from cervical cancer globally by as much as 90%. The purpose of our study was to explore multi-level barriers and facilitators to implementation of a national HPV vaccine program in the Dominican Republic; this article focuses on parent-level barriers and facilitators. In this qualitative study, we conducted six focus groups (N = 64) with parents of school-age children in the Santo Domingo area of the Dominican Republic, representing diverse socioeconomic groups and geographic settings. Thematic content analysis, using inductive and deductive approaches, was done following transcription and translation of audio-recordings from focus group discussions. Among this group of parents in the Santo Domingo area, facilitators to vaccine uptake were favorable attitudes towards vaccines in general and concern about cervical cancer as a health issue. Barriers found were low to moderate knowledge of HPV and cervical cancer, especially in the rural and suburban groups, and cost and lack of public awareness of the vaccine. This study identified key barriers and facilitators to HPV vaccine implementation in the Dominican Republic. Health messaging, incorporating specialist providers as opinion leaders, will need to be tailored to broad audiences with varying levels of information and awareness, anticipating misinformation and concerns, and will need to emphasize HPV vaccine as a method to prevent cancer.

Creating effective programs for cervical cancer prevention is essential to avoid premature deaths from cervical cancer. The Dominican Republic has persistently high rates of cervical cancer, despite the availability of Pap smear screening. This study explored Dominican provider attitudes towards human papillomavirus (HPV) testing and current challenges to effective cervical cancer prevention. In this Consolidated Framework for Implementation Research (CFIR)–driven mixed methods study, we conducted in-depth interviews (N = 21) and surveys (N = 202) with Dominican providers in Santo Domingo and Monte Plata provinces regarding their perspectives on barriers to cervical cancer prevention and their knowledge and attitudes towards HPV testing as an alternative to Pap smear. Providers believed the main barrier to cervical cancer prevention was lack of cervical cancer awareness and resulting inadequate population screening coverage. Providers felt that Pap smear was widely available to women in the Dominican Republic and were unsure how a change to HPV testing for screening would address gaps in current cervical cancer screening programs. A subset of providers felt HPV testing offered important advantages for early detection of cervical cancer and were in favor of more widespread use. Cost of the HPV test and target age for screening with HPV testing were the main barriers to acceptability. Providers had limited knowledge of HPV testing as a screening test. The group was divided in terms of the potential impact of a change in screening test in addressing barriers to cervical cancer prevention in the Dominican Republic. Findings may inform interventions to disseminate global evidence-based recommendations for cervical cancer screening.