Improved cervical screening uptake among local South Asian women following CUHK training

Expansion of a territory-wide cervical screening programme to train a group of local South Asian women has enabled education regarding cervical cancer and screening services among their peers, and considerably improved screening uptake.

Regular cervical screening has proven to be an effective way of preventing cervical cancer and associated mortality. [Br J Cancer 2016;115:1140-1146] Although a free cervical screening programme is available in Hong Kong, some ethnic minorities do not undergo screening due to language and cultural barriers.

“Despite the government’s efforts to emphasize the importance of early detection of cervical cancer and provide cervical screening services, their effectiveness in reaching local ethnic minorities has been limited. Out of the 1,016 South Asian women eligible for cervical screening that we reached out to [via a survey], 85 percent had never been screened for cervical cancer and 15 percent had not been screened for >3 years,” said Professor Jojo Wong of the Nethersole School of Nursing, Chinese University of Hong Kong (CUHK).

To address the unmet need, the CUHK team collaborated with >40 local nongovernmental organizations and South Asian community centres in order to recruit community health worker trainees. In total, they trained 52 women, who reached out to >1,000 of their peers in local communities, provided information about cervical cancer and cancer screening services, assisted with making cervical cancer screening appointments, and accompanied them to these appointments. Over three-quarters of women contacted by the community health workers eventually underwent cervical cancer screening. [https://www.med.cuhk.edu.hk/press-releases/cuhk-trains-local-south-asian-women-to-promote-cervical-screening]

The training programme is part of the Integrative Multicomponent Programme for Promoting South Asians’ Cancer Screening UpTake (IMPACT) project led by the Nethersole School of Nursing at CUHK and co-funded by the Knowledge Transfer Project Fund and the Social Innovation and Entrepreneurship Development Fund in 2022.

“The success of the IMPACT project illustrates the huge potential and capability of social capital in promoting public health, which has yet to be fully exploited. We are delighted to see the trust built between community health workers and their peers, with community health workers becoming a resource for accessing health information and cancer screening services,” remarked Professor Winnie So of the Nethersole School of Nursing. “We are expecting a ripple effect, which can bring us even closer to our ultimate goal of reaching all eligible South Asians in Hong Kong.”

“Cultural norms were among the challenges we encountered while implementing the project. For instance, [some of the women we contacted] saw a need to seek permission from their husbands to take part in screening. This reflects a need to educate not only eligible women but also their family members about the importance and purpose of cervical cancer screening,” noted Professor Dorothy Chan of the Nethersole School of Nursing.

Based on their experience, the project team and partnering organizations made a recommendation for collaboration between healthcare research teams, district health centres, general practitioners, and community organizations serving local ethnic minorities, which would promote health programmes in the general public.