<b>UNDERSTANDING DISPARITIES IN CERVICAL CANCER SCREENING AMONG HISPANIC WOMEN IN INDIANA FOR FUTURE INITIATIVES</b>

<p dir="ltr">No woman should die from cervical cancer. Yet, every 2 minutes somewhere in the world a life is lost to this disease. Almost all cases are linked to human papillomavirus (HPV), a common sexually transmitted infection that usually clears on its own but can lead to cancer if infection persists. Cervical cancer is preventable, treatable and curable. It is highly preventable, through the HPV vaccine and regular screening throughout adulthood. Screening is key to detecting it early. Despite prevention methods disparities remain. In the U.S. Hispanic women face high rates of cervical cancer incidence and mortality. Hispanic women are more likely to be overdue for screening leading to later stage diagnosis when treatment is difficult and survival is lower. Typical barriers to screening include lack of health insurance, financial constraints, access to health care settings, fear and limited knowledge about cervical cancer and screening. Primary HPV testing is a screening method used as a standalone test which checks for high-risk types of HPV. Cervical cancer screening guidelines recommend primary HPV testing as the preferred screening method, opening the door to self-sampling which allows women to collect their own cervicovaginal swab sample, in a private, comfortable setting of their choice. Research shows that these samples are as accurate as clinician collected samples. Recently, US FDA approvals have introduced this method for in clinic settings and have expanded to a new self-sampling device for at home screening. However, these methods are not yet reaching those that need it most, the technology is there but the connection to the community is missing. Community health workers (CHWs) are frontline health professionals who are trusted and familiar with the communities they serve linking people to services to improve their health. CHWs can bridge the gaps between cervical cancer education, self-sampling and the communities they serve. My research identifies key disparities in cervical cancer screening behaviors, knowledge, and barriers among Hispanic women. It explored perspectives on alternative screening modalities by examining factors that influence willingness to adopt self-sampling for cervical cancer screening and engage with CHWs for cervical cancer education and service. This work also delves into how those disparities impact screening behaviors, shaped by the intersection of determinants and identities that create compounded barriers to screening for vulnerable populations. To address these challenges, the research also identifies specific barriers and facilitators to self-sampling from the perspectives of key informants in screening: healthcare providers, Hispanic women and CHWs, that must be considered for implementation and uptake of methods that can reduce barriers to screening in this populations.</p>