Compliance with recommended cervical and breast cancer screenings among emergency department patients and visitors assessed by research associates.
Authors: Illuzzi F, Rush L, Lat C, Rose A, Bradley K
Objectives: The goal of this study was to assess the potential need for providing elements of cervical and breast cancer screening among emergency department patients and visitors. The specific objective of the study was to determine the compliance with the American Cancer Society's (ACS) Pap test and mammography screening recommendations among a group of non-critical patients and visitors in an urban, community hospital emergency department as identified by Research Associates (RAs). Methods: This was a convenience sample survey performed by RAs, pre-health professions college students trained as case finders and data collectors. They served a minimum of one 4-hour shift per week in the Emergency Department during a summer academic semester. There was no attempt at sampling. RAs were simply encouraged to approach and enroll as many adult women patients and visitors as possible. The numbers of patients approached and subjects entered by each RA were key components of their letter of evaluation.
Inclusion criteria were adult, female, non-urgent patients and visitors ≥ 20 years old. Potential subjects were excluded from the study if they refused to participate, were judged to be too sick, clinical activities took precedence or the RA could not communicate with them for any reason, such as language barrier or altered mental status.
Following a scripted introduction, the following data were collected for each subject: 1) age, ethnicity, and insurance status, 2) whether they had a primary care practitioner (PCP) and location and timing of their latest visit, 3) compliance with ACS screening recommendations for cervical and breast cancer screening, i.e., Pap test and, for subjects ≥ 40 years old, mammography. In order to be compliant with ACS recommendation, subjects should have: 1) seen their PCP, 2) had a Pap test and, 3) if appropriate, a mammogram yearly. Informed consent was obtained from all subjects enrolled in the study.
Results: Forty-nine RAs served shifts over 20 weeks in the spring and summer semesters, 2007. Among the 949 patients and visitors approached, 603 subjects (64%) were enrolled. Subjects' average age was 65 years (range 45-98 years); African American 17%, Caucasian 76%, Hispanic 7%, Other >1%. A PCP was identified by 546 subjects (91%). Eighty-five percent (85%) had seen their PCP within one year recommended for cancer screening. For PSA testing, 65% had been tested at some time with 56% having had the test within the preceding 12 months. For DRE, 87% indicated they had been so examined at some time with 62% having had the examination within 12 months.
Conclusion: Among non-urgent ED patients and visitors, RAs identified a large number of subjects who indicated they were not in compliance with ACS recommended prostate cancer. EDs can be an important venue for detecting persons in need of prostate cancer screening.
