1. HPV self-collection among unhoused patients
- Implementation of Human Papillomavirus self-collection and barriers to follow-up among unhoused individuals in Texas in Obstetrics and Gynecology
Human papillomavirus (HPV) causes almost all cervical cancer, and while HPV vaccination and screening have successfully reduced cancer rates, barriers remain. Healthcare inequality profoundly affects unhoused individuals. Cervical cancer screening rates are only about 19% among unhoused individuals due to barriers like cost, transportation, and stigma. In 2024, the US Food and Drug Administration (FDA) approved primary HPV testing, including self-collection, creating an opportunity for expanded access to screening services. This study, based out of the MD Anderson Cancer Center in Texas, evaluated the feasibility of self-collected HPV testing and follow-up for unhoused people. 87 subjects were enrolled and provided samples. The authors found that self-collection was acceptable to subjects, but follow-up for abnormal results was extremely difficult: participants lacked reliable contact methods, transportation, and ability to navigate scheduling. While this study demonstrates the usefulness of self-screening in a medically underserved population, it also highlights an ongoing need for resources and support for unhoused individuals. Without improved patient navigation support, HPV self-screening would fail to be a meaningful tool for addressing health disparities among unhoused individuals.
2. Updated breast cancer screening recommendations
- Recommendations from the women’s preventive services initiative on breast cancer screening for women at average risk and patient navigation services for breast and cervical cancer screening in Obstetrics and Gynecology
The Women’s Preventive Services Initiative (WPSI) is a national coalition of healthcare organizations and other experts in reproductive healthcare that maintains up to date recommendations for preventive services for female-bodied individuals. This updated document builds on prior recommendations that females of average risk should initiate breast cancer screening between ages 40-50 and continue through age 74. The guidance now includes a specific algorithm for additional imaging and/or pathology evaluation when abnormal findings are noted. Furthermore, after reviewing extensive published literature, the WPSI also recommends creating patient navigation services for the breast cancer screening process, which have been shown to improve screening rates by addressing barriers like transportation, language, or need for reminders. Ideally, these services should be insurance-covered with minimal copays. The aim: more equitable access to breast and cervical cancer screening.
3. Clinician confidence about adolescent abortion access
- Navigating a new frontier: An exploratory study of clinicians’ confidence in their ability to help adolescents access abortion post-Dobbs in Contraception
Pregnant adolescents and young adults face numerous barriers to abortion access, which have only worsened after Dobbs v Jackson in 2022. While many of these barriers, like parental consent laws and later pregnancy recognition are well-established, less is known about how this population receives information about abortion from their health care providers. In a survey of 188 clinicians caring for adolescents, a minority reported high confidence in referring adolescents for abortion care, and this confidence was lower for clinicians living in a state with post-Dobbs restrictions. Results point to significant abortion knowledge gaps for clinicians to care for adolescents and underscore the need for provider education on adolescent abortion access.
4. Asynchronous medication abortion care
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