October 18, 2023

U-M CDHW Member Dr. Diane Harper Awarded Grant Related to Cervical Cancer Screening among BIPOC and AI/AN Women with Physical Disabilities

Diane M. Harper, MD, MPH, MS, an internationally recognized family physician and clinical research expert, was recently awarded an American Cancer Society Screening Priority Area grant to study self-sampling for cervical cancer screening among Black, Indigenous, and people of color (BIPOC) and American Indian/Alaska Native (AI/AN) women with physical disabilities (WWPD).

The human papillomavirus (HPV) causes cervical cancer through sexual transmission. Testing for HPV is usually performed in a doctor’s office and can be intimidating and costly. As testing evolves, so does the possibility of testing at home and through the mail. Dr. Harper will be studying two self-screening methods for HPV and has invited BIPOC and AI/AN WWPD who are sexually active to participate.

Over 94% of WWPD have had sexual activity with a partner in their lifetime, sometimes through abusive relationships. WWPDs are half as likely to have cervical cancer screening as women who are not disabled. They are more likely to have late-stage cervical cancers at diagnosis and are more likely to die from cervical cancer than women who are not disabled. Black women have 2.5 times the rate of physical disability as White women. Native Americans have the highest rate of physical disability of all races. BIPOC women without disabilities have twice the rate of developing cervical cancer and four times the rate of dying from cervical cancer as White women.

This project has three aims:

  1. Recruit a small number of Black, Indigenous, and people of color (BIPOC) women with physical disabilities (WWPD) to focus on the acceptability and preference of four possible self-sampling kits.
  2. Enroll a racially diverse group of WWPD to pilot test the most acceptable and feasible kits from the first aim.
  3. Determine the risk factors for cervical cancer screening from a large national medical insurance claims database. The Optum Database has 80 million unique people’s insurance information from the past ten years, linking the medical provider to the care given. In addition, Medicaid includes Indigenous/Indian Health Service utilization. They are particularly interested in looking at the prevalence of initial and subsequent cervical cancer screenings, and the timing of when these occur among women with and without physical disabilities. They will also look for any disparities related to disability type (acquired vs congenital), age, race/ethnicity, and location in the US.