scholarly journals Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities

2021 ◽  
Vol 18 (12) ◽  
pp. 6556
Author(s):  
Chelsea Salyer ◽  
Ashlyn Lipnicky ◽  
Meredith Bagwell-Gray ◽  
Jennifer Lorvick ◽  
Karen Cropsey ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Kansas City ◽  
Provider Communication ◽  
Hpv Testing ◽  
Community Settings ◽  
Pap Testing ◽  
Care Plans ◽  
Follow Up Care ◽  
Specific Provider

Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities—Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing (n = 15, 38%), or colposcopy and/or biopsy (n = 14, 35%). Women who did not follow-up (n = 15, 26%) cited that they forgot (n = 8, 53%), were uninsured (n = 3, 20%), or were reincarcerated (n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3–16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1–13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.

scholarly journals Clinical Human Papillomavirus Detection Forecasts Cervical Cancer Risk in Women Over 18 Years of Follow-Up

2012 ◽  
Vol 30 (25) ◽  
pp. 3044-3050 ◽  
Author(s):  
Philip E. Castle ◽  
Andrew G. Glass ◽  
Brenda B. Rush ◽  
David R. Scott ◽  
Nicolas Wentzensen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Risk ◽  
Clinical Test ◽  
Low Grade ◽  
Hpv Testing ◽  
Pap Testing ◽  
Health Maintenance ◽  
Hpv Test

Purpose To describe the long-term (≥ 10 years) benefits of clinical human papillomavirus (HPV) DNA testing for cervical precancer and cancer risk prediction. Methods Cervicovaginal lavages collected from 19,512 women attending a health maintenance program were retrospectively tested for HPV using a clinical test. HPV positives were tested for HPV16 and HPV18 individually using a research test. A Papanicolaou (Pap) result classified as atypical squamous cells of undetermined significance (ASC-US) or more severe was considered abnormal. Women underwent follow-up prospectively with routine annual Pap testing up to 18 years. Cumulative incidence rates (CIRs) of ≥ grade 3 cervical intraepithelial neoplasia (CIN3+) or cancer for enrollment test results were calculated. Results A baseline negative HPV test provided greater reassurance against CIN3+ over the 18-year follow-up than a normal Pap (CIR, 0.90% v 1.27%). Although both baseline Pap and HPV tests predicted who would develop CIN3+ within the first 2 years of follow-up, only HPV testing predicted who would develop CIN3+ 10 to 18 years later (P = .004). HPV16- and HPV18-positive women with normal Pap were at elevated risk of CIN3+ compared with other HPV-positive women with normal Pap and were at similar risk of CIN3+ compared with women with a low-grade squamous intraepithelial Pap. Conclusion HPV testing to rule out cervical disease followed by Pap testing and possibly combined with the detection of HPV16 and HPV18 among HPV positives to identify those at immediate risk of CIN3+ would be an efficient algorithm for cervical cancer screening, especially in women age 30 years or older.

scholarly journals Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing

2020 ◽  
Vol 130 ◽  
pp. 105928
Author(s):  
Erika L. Thompson ◽  
Annalynn M. Galvin ◽  
Ellen M. Daley ◽  
Ovidiu Tatar ◽  
Gregory D. Zimet ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Testing ◽  
Pap Testing ◽  
Screening Guidelines

Variations in recommended surveillance in colorectal cancer survivorship care plans.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 13-13
Author(s):  
Alaina Chodoff ◽  
Katherine Clegg Smith ◽  
Aishwarya Shukla ◽  
Amanda L. Blackford ◽  
Nita Ahuja ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Risk ◽  
Controlled Trial ◽  
Center Frequency ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

13 Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773 . [Table: see text]

scholarly journals Quality of Patient-Provider Communication Among Cancer Survivors: Findings From a Nationally Representative Sample

2016 ◽  
Vol 12 (12) ◽  
pp. e964-e973 ◽  
Author(s):  
Neetu Chawla ◽  
Danielle Blanch-Hartigan ◽  
Katherine S. Virgo ◽  
Donatus U. Ekwueme ◽  
Xuesong Han ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Social Needs ◽  
Provider Communication ◽  
Communication Quality ◽  
Follow Up Care ◽  
Patient Provider Communication ◽  
Lifestyle Recommendations

Purpose: Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer. Methods: Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from “did not discuss” to “discussed in detail,” a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses. Results: At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married. Conclusion: Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.

scholarly journals PS1-25: Cervical Cancer Testing and Follow-up in Four Managed Care Plans, 1998-2007

2012 ◽  
Vol 10 (3) ◽  
pp. 150-151
Author(s):  
S. Weinmann ◽  
E. Masterson ◽  
H. Gold ◽  
A. Kamineni ◽  
A. Williams ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Managed Care ◽  
Care Plans

scholarly journals Development of an interactive, web-based shared care plan to facilitate the follow-up care of colorectal cancer patients

2019 ◽  
Author(s):  
Jane Taggart ◽  
Melvin Chin ◽  
Winston Liauw ◽  
Alex Dolezal ◽  
John Plahn ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Information ◽  
Shared Care ◽  
Care Plan ◽  
Web Based ◽  
Care Plans ◽  
Cancer Services ◽  
Follow Up Care ◽  
Primary Care Practitioners

Abstract Introduction A shared model of care between cancer services and primary health care is safe and acceptable and can address the increasing demands on cancer services for long term follow-up. This paper describes the challenges developing an interactive shared care plan for colorectal cancer follow-up care that supports collaboration between the care team and patient. Methods A systematic literature review was undertaken to identify web-based care plans for follow-up cancer care that would inform the implementation of a system to share an individualised care plan. We conducted individual consultations with 25 key informants/stakeholders to understand the requirements and challenges of establishing the web-based care plan and to identify the technical options to share the care plan. This was followed by a structured group consultation with 13 key stakeholders to obtain agreement on the model of care and the technical solution to share the care plan. Results We identified five web-based shared care plans for cancer follow-up care. These systems supported the creation and/or access to view or share the care plan via internet log-in, email or hard copy. None of the SCP had interactive functionalities to support collaboration and none of the included papers reported formalised models of shared care between cancer services and primary care. The challenges identified included the security, privacy and sharing of patient information between public health services and primary health care and poor integration of clinical information systems. A primary care practitioners’ care planning system was selected for the pilot as it addressed the challenge of sharing clinical information between the public health system and external clinicians, partially addressed integration (integrated with the primary care clinical information systems but did not integrate with the cancer centre systems), supported collaboration between the care team and patient and was relatively inexpensive. Conclusion Primary care shared care planning systems seem a suitable option for sharing clinical information between a cancer service and primary care practitioners. We plan to evaluate the feasibility and acceptability of this interactive shared care plan to support shared cancer follow-up care.

The use of electronic health record systems to create treatment summaries and survivorship care plans.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 56-56
Author(s):  
Katherine Ramsey Gilmore ◽  
David K Choi ◽  
Patricia Chapman ◽  
Paula A. Lewis-Patterson ◽  
Guadalupe R. Palos ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
Treatment Summaries ◽  
Care Plans ◽  
Patient Level ◽  
Follow Up Care ◽  
Electronic Health

56 Background: The Commission on Cancer’s recent mandate stated that accredited programs issue treatment summaries (TSs) with survivorship follow-up care plans (SCPs). ASCO’s model of survivorship care also supports the use of these documents. One of the primary purposes of the documents is to enhance coordination and communication between the oncology team and primary care providers. Here we describe the experience of a survivorship program in using electronic health records (EHR) to develop TSs and SCPs. Methods: An interdisciplinary team at an academic cancer center was appointed to develop clinical tools to facilitate the creation and dissemination of TSs and SCPs. Enhancements were made to an institutional off-the-shelf EHR system that automatically populated available treatment information to the TS. This system used SmartLinks to pull data from the primary source of entry (e.g. surgical history, chemotherapy administered, and cancer stage). Clinicians edited and added pertinent information not automatically generated using one of the 19 disease-specific templates that provided lists of common treatments for various cancers. Electronic routing functions existed to share TSs with external providers through the medical records department. Results: From March-Sept, 2016, 766 SCP were completed by 50 providers in 14 clinics. Reports were created in the EHR to track SCPs and TS metrics. Data was reported from the TS on both a patient level and aggregate level by provider and clinic. Patient level data allowed providers to track incomplete TSs and edit them directly from the report. Of the TSs completed, 528 (69%) have been shared with patients and 261 (34%) have been shared with their community-based providers. Conclusions: EHRs provide a mechanism to successfully create and share TSs and SCPs among team members and primary care providers. They promote patient-provider education and communication about follow-up care. Research is needed to determine how they enhance coordination and ultimately outcomes for long-term survivors.

Promising strategies for cervical cancer screening in the post-human papillomavirus vaccination era

Sexual Health ◽  
2010 ◽  
Vol 7 (3) ◽  
pp. 376 ◽  
Author(s):  
Joseph Tota ◽  
Salaheddin M. Mahmud ◽  
Alex Ferenczy ◽  
François Coutlée ◽  
Eduardo L. Franco
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Human Error ◽  
Pap Smear ◽  
Cervical Screening ◽  
Screening Tests ◽  
Hpv Testing ◽  
Human Papillomavirus Vaccination ◽  
Screening Programs

Human papillomavirus (HPV) vaccination is expected to reduce the burden of cervical cancer in most settings; however, it is also expected to interfere with the effectiveness of screening. In the future, maintaining Pap cytology as the primary cervical screening test may become too costly. As the prevalence of cervical dysplasias decreases, the positive predictive value of the Pap test will also decrease, and, as a result, more women will be referred for unnecessary diagnostic procedures and follow-up. HPV DNA testing has recently emerged as the most likely candidate to replace cytology for primary screening. It is less prone to human error and much more sensitive than the Pap smear in detecting high-grade cervical lesions. Incorporating this test would improve the overall quality of screening programs and allow spacing out screening tests, while maintaining safety and lowering costs. Although HPV testing is less specific than Pap cytology, this issue could be resolved by reserving the latter for the more labour-efficient task of triaging HPV-positive cases. Because most HPV-positive smears would contain relevant abnormalities, Pap cytology would be expected to perform with sufficient accuracy under these circumstances. HPV Pap triage would also provide a low-cost strategy to monitor long-term vaccine efficacy. Although demonstration projects could start implementing HPV testing as a population screening tool, more research is needed to determine the optimal age to initiate screening, the role of HPV typing and other markers of disease progression, and appropriate follow-up algorithms for HPV-positive and Pap-negative women.

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