Christman Mitalee P, Castro-Zarraga Margarita, Defaria Yeh Doreen, Liberthson Richard R, Bhatt Ami B
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
ISRN Cardiol. 2013 Aug 1;2013:827696. doi: 10.1155/2013/827696. eCollection 2013.
Adults with congenital heart disease (ACHD) face noncardiac healthcare challenges as the population ages. We assessed whether women with ACHD have comparable cancer screening rates to non-ACHD women in a cardiac practice and to the general population. We performed a retrospective review of 175 adult women seen in a cardiac care center in 2009-2011. Data on Pap tests, mammography, and colonoscopies, were collected through electronic medical records and primary care provider records. Adequate documentation was available for 100 individuals with ACHD and 40 comparator cardiac patients. The adequacy of screening was determined using guidelines set forth by the American Cancer Society in 2010. Compared with the national average, ACHD patients had significantly lower rates of Pap tests (60% versus 83%, P < 0.001) and mammography (48% versus 72%, P < 0.001). Compared with non-ACHD women in the same practice, ACHD patients had consistently lower rates of mammography (48% versus 81%, P = 0.02) and colonoscopies (54% versus 82%, P = 0.23). As the population of ACHD individuals ages, attention to cancer screening becomes increasingly important but may be overlooked in this population. Primary care physicians and cardiologists should collaborate to ensure appropriate cancer screening for this growing population.
随着年龄增长,患有先天性心脏病(ACHD)的成年人面临着非心脏医疗保健方面的挑战。我们评估了患有ACHD的女性在心脏科的癌症筛查率是否与非ACHD女性以及普通人群相当。我们对2009年至2011年在一家心脏护理中心就诊的175名成年女性进行了回顾性研究。通过电子病历和初级保健提供者记录收集了巴氏试验、乳房X光检查和结肠镜检查的数据。有100名ACHD患者和40名对照心脏病患者有足够的记录。筛查的充分性是根据美国癌症协会2010年制定的指南确定的。与全国平均水平相比,ACHD患者的巴氏试验率(60%对83%,P<0.001)和乳房X光检查率(48%对72%,P<0.001)显著较低。与同一科室的非ACHD女性相比,ACHD患者的乳房X光检查率(48%对81%,P = 0.02)和结肠镜检查率(54%对82%,P = 0.23)一直较低。随着ACHD患者群体的老龄化,对癌症筛查的关注变得越来越重要,但这一群体可能会被忽视。初级保健医生和心脏病专家应合作,确保为这一不断增长的群体进行适当的癌症筛查。