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Pithavadian R, Dune T, Chalmers J. Patients' recommendations to improve help-seeking for vaginismus: a qualitative study. BMC Womens Health 2024; 24:203. [PMID: 38555422 PMCID: PMC10981325 DOI: 10.1186/s12905-024-03026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Research to improve healthcare experiences for women with vaginismus tends to be produced from the perspective of healthcare professionals or health-based researchers. There is lacking research on women's experiences and recommendations to improve help-seeking for vaginismus from their perspective. To address this research gap, this qualitative study aimed to identify the issues that women face when help-seeking for vaginismus and their recommendations to address it. This sought to support the wellbeing of patients to advocate for their healthcare needs which is often overlooked. METHODS Using a feminist theoretical approach, semi-structured interviews were conducted with 21 participants who sought help for their vaginismus. Thematic analysis was employed to analyse participants' recommendations. RESULTS Four main themes emerged: Increase awareness of vaginismus, Dismantle myths about sex, Destigmatise vaginismus, and Empower people with vaginismus during medical consultations. Subthemes were identified as actionable strategies that participants recommended to improve help-seeking and healthcare for vaginismus. CONCLUSIONS The findings from this study can inform healthcare practice and policy to foster better synchronicity between health professionals and their patients' perceptions and expectations of treating vaginismus. This can promote more acceptance of patients' advocacy of their needs and goals to improve the therapeutic alliance and treatment outcomes for vaginismus in healthcare practice. The strategies recommended to increase awareness of vaginismus and challenge its stigma should be considered in policy to incite a culture of change in healthcare practice and broader society.
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Affiliation(s)
- Rashmi Pithavadian
- School of Health Sciences, PhD Candidate, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Tinashe Dune
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, Australia
| | - Jane Chalmers
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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2
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Dieleman M, de Waard J, Wisman GBA, Schuuring E, Esajas MD, Vermeulen KM, de Bock GH. Preferences and Experiences Regarding the Use of the Self-Sampling Device in hrHPV Screening for Cervical Cancer. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 15:245-253. [PMID: 34558035 PMCID: PMC8866331 DOI: 10.1007/s40271-021-00550-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND To improve participation in the Dutch cervical cancer screening, a self-sampling device (SSD) was introduced in 2017 into the Dutch population-based screening programme (PBS) for the early detection of cervical cancer. The aim of this study was to gather potential preferences and experiences that might influence a woman's decision to use the SSD in the Dutch PBS. METHODS A scoping review was performed in the PubMed database. Studies that assessed preferences and experiences of women regarding the SSD were included, and preferences and experiences were extracted. In addition, in a qualitative study, the list of potential preferences and experiences specific for the Dutch PBS was extended based on semi-structured interviews with SSD users as well as non-SSD users who recently participated in the PBS, analysed in a structured manner by translating full sentences to key words. RESULTS Ninety-eight studies were included in the scoping review and 16 interviews were performed. Frequently mentioned reasons for using the SSD, in both the interviews and the literature, were practicality and comfort. Frequently mentioned reasons for not using the SSD were fear of not performing the SSD procedure correctly and doubts on whether the results of the high-risk human papillomavirus (hrHPV) test will be reliable. A new positive experience elicited in the interviews was accessibility. Negative preferences and experiences were not being aware the SSD was an option, and the inconvenience that after an hrHPV-positive test result of the SSD, an additional smear test at the GP is necessary. CONCLUSION Several preferences and experiences play a role in the choice whether or not to use the SSD. Based on the currently found preferences and experiences, an app will be developed in order to assess which of these are the most important for women participating in the Dutch population-based cervical screening programme.
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Affiliation(s)
- Marjolein Dieleman
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Huispostcode FA40, PO BOX 30 001, 9700 RB, Groningen, The Netherlands
| | - Jolien de Waard
- Department of Gynaecologic Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - G Bea A Wisman
- Department of Gynaecologic Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ed Schuuring
- Department of Pathology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Martha D Esajas
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Huispostcode FA40, PO BOX 30 001, 9700 RB, Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Huispostcode FA40, PO BOX 30 001, 9700 RB, Groningen, The Netherlands.
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Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186892. [PMID: 32967173 PMCID: PMC7559737 DOI: 10.3390/ijerph17186892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/12/2020] [Accepted: 09/18/2020] [Indexed: 01/21/2023]
Abstract
Cervical cancer can be largely preventable through primary and secondary prevention activities. Following the financial crisis in Greece since 2011 and the increased number of refugees/migrants since 2015 the proportion of vulnerable population groups in Greece increased greatly and the ability of the healthcare sector to respond and to cover the health needs of the population is put under tremendous stress. A cross-sectional study was designed to assess the characteristics of vulnerable women in Greece regarding cervical cancer risk factors, prevention through screening activities and Human Papilloma Virus (HPV) knowledge. Two cohorts of women aged 18 to 70 years were studied (142 in 2012 and 122 in 2017) who completed an interviewer-administered questionnaire based on the behavioural model for vulnerable populations. According to this model, the factors that affect the behaviour of women in relation with their knowledge, attitudes and beliefs towards cervical cancer and the HPV vaccine in our study sample are categorised in predisposing factors (age, educational status, nationality menopausal status and housing) and enabling factors (lack of insurance coverage). Results from both univariate and multivariate analyses show that older age, low educational background, refugee/migrant or ethnic minority (Roma) background, menopausal status, housing conditions and lack of insurance coverage are linked with insufficient knowledge on risk factors for cervical cancer and false attitudes and perceptions on cervical cancer preventive activities (Pap smear and HPV vaccine). This is the first study in Greece showing the lack of knowledge and the poor attitudes and perceptions on cervical cancer screening and the HPV vaccine in various groups of vulnerable women. Our results indicate the need of health education and intervention activities according to the characteristics and needs of each group.
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4
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Parajuli J, Horey D, Avgoulas M. Best practice models recommended by Bhutanese refugee women for cervical and breast cancer screening in Australia: A qualitative study. Health Promot J Austr 2020; 31:381-390. [DOI: 10.1002/hpja.315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/27/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jamuna Parajuli
- School of Psychology and Public Health La Trobe University Bundoora Vic. Australia
| | - Dell Horey
- School of Psychology and Public Health La Trobe University Bundoora Vic. Australia
| | - Maria‐Irini Avgoulas
- School of Psychology and Public Health La Trobe University Bundoora Vic. Australia
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5
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Latifi M, Alishan Karami N, Beiraghdar M, Maraki F, Allahbakhshian Farsani L. Impact of Health Information Prescription on Self-care of Women with Breast Cancer. Adv Biomed Res 2018; 7:139. [PMID: 30505810 PMCID: PMC6233030 DOI: 10.4103/abr.abr_142_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Women with breast cancer experience various challenges. Prescription of health information provides appropriate information at appropriate time to the appropriate person and plays a role in empowering self-care and improving health. The current research aims to evaluate the effect of health information prescription on self-care power of women with breast cancer. Materials and Methods: This semi-experimental quantitative study was done using pretest and posttest method in one group of 61 women with breast cancer selected from the Women's Cancer Center of Khatamolanbia Hospital using purposive sampling method. Data were collected by an author-made self-care questionnaire and patients' self-care score was calculated at the first visit (before health information prescription) and the second visit (after health information prescription). Data were analyzed using the SPSS version 23 software and analysis of variance at a statistical significance level of P < 0.05. Results: Total mean score of self-care in women with breast cancer was 40.97 and 115.3 before and after health information prescription, respectively. Increase of mean was observed in all subscales of self-care score from pretest to posttest so that change in posttest was higher in subscales of effective implementation of treatment and prevention from disabilities and personal functioning regulation (39.44), specialized knowledge on breast cancer (30.46), searching medical services and cooperation with treatment group (28.59), and awareness and attention to impacts and results of breast cancer (16.81). Conclusion: Health information prescription improves self-care power of women with breast cancer, and it is necessary to provide health information services in order to support women's self-care by the health authorities.
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Affiliation(s)
- Masoomeh Latifi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nader Alishan Karami
- Department of Health Information Technology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mozhdeh Beiraghdar
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Maraki
- Department of Operating Room, Isfahan University of Medical Sciences, Isfahan, Iran
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6
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Musa J, Achenbach CJ, Evans CT, Jordan N, Daru PH, Hou L, Murphy RL, Adewole IF, Simon MA. Association between patient-reported HIV status and provider recommendation for screening in an opportunistic cervical Cancer screening setting in Jos, Nigeria. BMC Health Serv Res 2018; 18:885. [PMID: 30466437 PMCID: PMC6251217 DOI: 10.1186/s12913-018-3700-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cervical cancer screening (CCS) is an important health service intervention for prevention of morbidity and mortality from invasive cervical cancer. The role of provider recommendation and referral is critical in utilization of this services particularly in settings where screening is largely opportunistic. We sought to understand how patient-reported human immunodeficiency virus (HIV) infection status is associated with provider referral in an opportunistic screening setting. METHODS We performed a cross-sectional analysis of data on a sample of women who had received a CCS at the "Operation Stop" cervical cancer (OSCC) screening service in Jos, Nigeria over a 10-year time period (2006-2016). We used the de-identified records of women who had their first CCS to analyze the association between patient-reported HIV and likelihood of provider-referral at first CCS. We performed descriptive statistics with relevant test of association using Student t-test (t-test) for continuous variables and Pearson chi square or Fisher exact test where applicable for categorical variables. We also used a bivariable and multivariable logistic regression models to estimate the independent association of patient-reported HIV on provider referral. All statistical tests were performed using STATA version 14.1, College Station, Texas, USA. Level of statistical significance was set at 0.05. RESULTS During the 10-year period, 14,088 women had their first CCS. The reported HIV prevalence in the population was 5.0%; 95% CI: 4.6, 5.4 (703/14,088). The median age of women who were screened was 37 years (IQR; 30-45). Women who were HIV infected received more referrals from providers compared to women who were HIV uninfected (68.7% versus 49.2%), p-value < 0.001. Similarly, we found an independent effect of patient-reported HIV infection on the likelihood for provider-referral in the screened sample (aOR = 2.35; 95% CI: 1.95, 2.82). CONCLUSION Our analysis supports the design of health systems that facilitates providers' engagement and provision of necessary counseling for CCS in the course of routine clinical care. The practice of offering recommendation and referrals for CCS to women at high risk of cervical cancer, such as HIV infected women should be supported.
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Affiliation(s)
- Jonah Musa
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Jos, Plateau State, Nigeria.
| | - Chad J Achenbach
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Charlesnika T Evans
- Department of Preventive Medicine, Center for Health Care Studies, Global Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Neil Jordan
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Department of Psychiatry & Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Patrick H Daru
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Jos, Plateau State, Nigeria
| | - Lifang Hou
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Robert L Murphy
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Isaac F Adewole
- Federal Ministry of Health, Federal Secretariat Complex, Central Business District, Federal Capital, Abuja, Nigeria
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
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Wallington S, Oppong B, Dash C, Coleman T, Greenwald H, Torres T, Iddirisu M, Adams-Campbell LL. A Community-Based Outreach Navigator Approach to Establishing Partnerships for a Safety Net Mammography Screening Center. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:782-787. [PMID: 27995458 PMCID: PMC5940570 DOI: 10.1007/s13187-016-1152-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Washington, DC, has one of the highest incidence and mortality rates for breast cancer in the USA. Patient navigation coupled with informational and community resources are important strategies that assist patients' access and help them understand the complex world of cancer care. The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that utilizes a community-based navigation program. In addition to providing assistance with coordination of clinical services, navigators at CBCC are integral in establishing intra-community partnerships to educate members of the community about breast cancer screening. The aim of this study was to detail the role of patient navigation at the CBCC, with an emphasis on community engagement and community-based partnerships. We describe the process by which CBCC established partnerships with multiple community organizations between 2004 and 2015 and analyzed data of women screened in relationship to the evolution of the patient navigation services. Application of the CBCC navigation model that integrates individual patient outreach with community engagement has yielded viable and lasting community partnerships that have resulted in an increase in mammography uptake, especially among medically underserved minority women.
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Affiliation(s)
| | - Bridget Oppong
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Chiranjeev Dash
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Tesha Coleman
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Holly Greenwald
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Tanya Torres
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Marquita Iddirisu
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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8
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Hei A, Dong X. Association Between Social Engagement and Cancer Screening Utilization in a Community-Dwelling Chinese American Older Population. Gerontol Geriatr Med 2018; 4:2333721418778184. [PMID: 30035194 PMCID: PMC6050613 DOI: 10.1177/2333721418778184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 09/25/2017] [Accepted: 11/30/2017] [Indexed: 11/26/2022] Open
Abstract
Objectives: This study aims to examine the association between social engagement and cancer screening utilization among a Chinese American older population. Method: Data were drawn from the Population Study of Chinese Elderly (PINE). In total, 3,157 Chinese older adults enrolled in this study. Cancer screening utilization was assessed by asking whether participants had utilized cancer screenings. Social engagement was measured with 16 questions. Results: After controlling for potential confounders, a higher level of social engagement was associated with increased utilization in blood stool test (OR 1.03, [1.02, 1.05]), colonoscopy (OR 1.02, [1.01, 1.03]), mammography (OR 1.06, [1.05, 1.08]), Pap test (OR 1.04, [1.03, 1.06]), and prostate specific antigen (PSA) test (OR 1.03, [1.01, 1.05]). Compared with those with low levels of social engagement, older adults with high levels of social engagement were more likely to have utilized a blood stool test (OR 1.85, [1.46, 2.35]), a colonoscopy (OR 1.37, [1.09, 1.72]), a mammography (OR 3.05, [2.25, 4.14]), and a Pap test (OR 1.99, [1.49, 2.66]), but not more likely to have utilized a PSA test (OR 1.40, [0.97, 2.03]). Conclusion: This study underscores the association between active social engagement and increased utilization of cancer screening among a Chinese American older population. Improving social engagement could be helpful in promoting cancer screening utilization.
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9
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Trosman JR, Carlos RC, Simon MA, Madden DL, Gradishar WJ, Benson AB, Rapkin BD, Weiss ES, Gareen IF, Wagner LI, Khan SA, Bunce MM, Small A, Weldon CB. Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery. J Oncol Pract 2016; 12:1101-1113. [PMID: 27577619 DOI: 10.1200/jop.2016.013573] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient's care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient's care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care.
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Affiliation(s)
- Julia R Trosman
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Ruth C Carlos
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Melissa A Simon
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Debra L Madden
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - William J Gradishar
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Al B Benson
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Bruce D Rapkin
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Elisa S Weiss
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Ilana F Gareen
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Lynne I Wagner
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Seema A Khan
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Mikele M Bunce
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Art Small
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
| | - Christine B Weldon
- Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC
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10
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Keshinro A, Hatzaras I, Rifkind K, Dhage S, Joseph KA. The Impact of Primary Care Providers on Patient Screening Mammography and Initial Presentation in an Underserved Clinical Setting. Ann Surg Oncol 2016; 24:692-697. [PMID: 27766557 DOI: 10.1245/s10434-016-5618-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis. Additional variables included race, age at diagnosis, family history of breast and ovarian cancer, and medical comorbidities. RESULTS Patients with a PCP received more mammograms (SMG) compared with patients without a PCP (61 vs. 37 %; p = 0.003). The majority (73 %) of patients without a PCP presented symptomatically with a palpable mass versus 42 % of patients with a PCP. A significant difference was noted with regard to final pathologic stage of breast cancer between the two groups (p = 0.019), and Caucasian and African American patients were more likely to have locally advanced breast cancer. CONCLUSIONS Underserved patients with a PCP are more likely to present asymptomatically and at an earlier stage of breast cancer compared with patients without a PCP. Community engagement programs that build relationships with patients may help bring vulnerable patients into the healthcare system for routine screening. Moreover, PCP education regarding the subtleties of breast cancer screening guidelines and referral to a breast specialist is also critical in improving outcomes of underserved patients.
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Affiliation(s)
- Ajaratu Keshinro
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Ioannis Hatzaras
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kenneth Rifkind
- Department of Surgery, NYU Langone Medical Center, NYU Lutheran Hospital, New York, NY, USA
| | - Shubhada Dhage
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kathie-Ann Joseph
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA.
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