Grant Number:	3R01CA258683-05S1 Interpret this number
Primary Investigator:	Dykens, Jon
Organization:	University Of Illinois At Chicago
Project Title:	Adaptation and Implementation of a Patient Navigation Program for Cervical Cancer Screening Across Contexts in Senegal
Fiscal Year:	2026

PROJECT SUMMARY ABSTRACT Cervical cancer mortality is expected to increase by 42% to 442,926 deaths worldwide by 2030. Due in large part to the low utilization of cervical cancer screening services, Senegal ranks 17th in the world for cervical cancer incidence, in line with other high-burden settings, including some medically underserved US communities. For women ages 40 to 49 in rural regions of Senegal, the cervical cancer screening rate is very low at less than 2%. As a result, women often present with mostly preventable late stage cancers. Secondary prevention programs (cervical cancer screening) are critical to effectively achieving global progress toward the elimination of human papillomavirus related cancers. Lessons learned from higher resource countries show that incidence and mortality rates decline and early deaths are prevented with early detection and appropriate follow-up and treatment. However, considerable context variation across geographic- and health system-levels markedly obstructs the community responsiveness of an implemented program. This results in slow uptake, poor follow-up, and low treatment rates for women who are screened positive. Patient navigation is a US developed strategy to eliminate barriers to screening, timely diagnosis, and follow-up to improve cancer outcomes in vulnerable populations. Patient navigation has demonstrated considerable effectiveness in its ability to address communication, information, medical system, and emotional barriers to timely care across all phases of the cancer care continuum, including detection, diagnosis, treatment, and post-treatment quality of life. Patient navigation programs enhance access to care, promote self-efficacy, and sustain patient engagement with care, and have been shown to improve cancer outcomes, particularly among marginalized groups, rural populations, and impoverished communities. This mixed methods research responds to identified intrapersonal- and community-level barriers to early cervical cancer screening uptake, follow-up, and treatment. We apply the Dynamic Adaptation Process to study the adaptation of an evidence-based cervical cancer patient navigation program in urban and rural contexts of Senegal, measure the intervention effectiveness, and evaluate implementation outcomes. This study prevents unnecessary deaths due to cervical cancer in Senegal and informs the prevention of cancer deaths among women who are low-income, uninsured, underinsured, or live in communities where barriers to screening, follow-up, and treatment persist. Many US safety-net clinics, rural health systems, federally qualified health centers, and public health programs face structurally similar constraints. This reciprocal innovation study is intentionally designed to adapt the US-based Patient Navigation construct into a context where significant barriers exist, including cancer-related stigma and women’s autonomy in healthcare decision-making. This study of the patient navigation model adaptation generates practical strategies for improving screening-to-treatment completion in Senegal and other similar contexts including US communities.





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