PS1-54: Clinical Perspectives on Under- and Overutilization of Cervical Cancer Screening Services.

Publication Type:

Journal Article

Source:

Clinical medicine & research, Volume 11, Issue 3, p.132 (2013)

Keywords:

2013, October 2013, Public Health Sciences Division

Abstract:

Background/Aims The underutilization of cancer screening services is an on-going concern to program planners and policy makers; such underutilization is common among under-insured, ethnic- and language-minority populations and is associated with advanced stage of disease detection, limited treatment options, and diminished survival. At the same time, growing research interest has focused on the over-utilization of cancer screening services. We sought to gather the perceptions of clinic personnel at Latino-serving federally qualified health centers about patients' utilization of screening services for cervical cancer. Methods We conducted one-on-one interviews among 17 clinic personnel at four Latino-serving federally qualified health center networks in Oregon. Results Estimated proportions of eligible patients who are under-screened ranged from 20% to 60%, with 30% most commonly cited. Under-screening for cervical cancer was thought to occur among low-income, under-insured and undocumented patients. External factors, such as limited funding to pay for screening and access barriers to follow-up testing in patients with positive screens were cited as contributing to under-screening. The most frequently cited proportion of eligible patients who are over-screened was 10%, and ranged from 10% to 50%. Notably, over-screening for cervical cancer was thought to occur among young women (those younger than 21) and women with a recent pregnancy. Inconsistent capture of history of screening in electronic medical records and unclear and changing screening guidelines were thought to contribute to over-screening in some patients. Conclusions The health care providers we interviewed had widely varying perspectives of the under- and over-utilization of screening services for cervical cancer. Our findings may inform future efforts to promote guideline-appropriate cancer screening and coordinated follow-up care.