Abstract
Purpose
American Indian/Alaska Native (AI/AN) populations experience significantly higher incidence and mortality rates of cervical cancer. The objective of this systematic scoping review is to characterize the volume and nature of research being conducted specific to the AI/AN population regarding cervical cancer and related clinical themes.
Methods
This scoping review was conducted in collaboration with the Pacific Northwest Evidence-based Practice Center. Search strategies identified eligible publications from 1990 through 4 February 2022. Two reviewers independently abstracted study data, including clinical area, number of participants and percent inclusion of AI/AN, intervention or risk factor, outcomes reported, Indian Health Service (IHS) Region, and funding source. We used published algorithms to assess study design.
Results
Database searches identified 300 unique citations. After full-text evaluation of 129 articles, 78 studies and 9 secondary publications were included (total of 87). Approximately 74% of studies were observational in design, with cross-sectional methodology accounting for 42.7% of all included studies. The most common clinical theme was cervical cancer screening. The most common intervention/exposure was risk factor, typically race (AI/AN compared with other groups) (69%). For studies with documented funding sources, 67% were funded by the US Government.
Conclusion
Of the small number of publications identified, the majority are funded through government agencies, are descriptive and/or cross-sectional studies that are hypothesis generating in nature, and fail to represent the diversity of the AI/AN populations in the US. This systematic scoping review highlights the paucity of rigorous research being conducted in a population suffering from a greater burden of disease.
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Data availability
The data that support the findings of this study are available in Ovid MEDLINE®, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials which are available via the URL/DOI cited in reference section.
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Funding
Author A. Bruegl is funded through the Robert Wood Johnson Foundation. Cirila Estela Vasquez Guzman is funded through a KL2 OCTRI award. The remaining authors have no funding sources to disclose.
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AB and RH contributed to the conceptualization of the project and data curation. AB and KF were involved in interpretation of data. KF was responsible for writing the original draft of the manuscript, creating Figs. 1, 2, 3 and 4, and implementing revisions. CN assisted with figure legends and edited the manuscript. CG contributed to conceptualization and edited the manuscript.
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Fitch, K.C., Nguyen, C.G.T., Vasquez Guzman, C.E. et al. Persistent cervical cancer disparities among American Indian/Alaska Native women: a systematic scoping review exploring the state of the science in this population. Cancer Causes Control 35, 193–201 (2024). https://doi.org/10.1007/s10552-023-01799-4
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DOI: https://doi.org/10.1007/s10552-023-01799-4