Stauder Sally K, Borkar Shalmali R, Najor Anna, Hunter Adrienne, DeStephano Christopher, Mohseni Michael
Florida State University College of Medicine, Tallahassee, Florida, USA.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
Womens Health Rep (New Rochelle). 2024 Sep 26;5(1):689-696. doi: 10.1089/whr.2024.0104. eCollection 2024.
Decreasing primary care access and increasing emergency department (ED) usage is a potential contributor to declining cancer screening prevalences in those facing barriers to health care access. The ED is a non-traditional yet potentially high-yield setting for implementation of interventions to monitor and increase cancer screening.
An ED-administered survey in July 2022 gathered data on breast, cervical, and colorectal cancer screening, as well as human papillomavirus (HPV) vaccination status of females presenting to the ED for care. This was compared with electronic health record (EHR) data extraction of all ED patients during the same timeframe. Primary outcome was proportion of cancer screening and HPV vaccination not up to date in each group.
ED survey was administered to 101 individuals; EHR data was extracted on 2934 patients. Survey versus EHR, respectively, found cervical cancer screening was not up to date in 6.2% vs. 77.6%, breast cancer screening in 14.3% vs. 73.4%, colorectal cancer screening in 22.9% vs. 56.5%, and HPV vaccination in 33.3% vs. 57.8%. value was < 0.001 for all screening category comparisons between survey and EHR.
Our data indicate significant discrepancies between self-reported screening history and EHR data. ED survey results were more in line with the observed screening rates in various surveillance systems and published in the literature. This suggests that point-of-care ED survey administration may be more effective in identifying those needing preventative cancer screening, especially in individuals with less access to routine health care.
初级保健服务可及性降低以及急诊科（ED）使用量增加，可能是导致那些面临医疗保健障碍的人群癌症筛查普及率下降的一个因素。急诊科是实施监测和增加癌症筛查干预措施的非传统但潜在高收益场所。
2022年7月在急诊科进行的一项调查收集了前来急诊科就诊的女性的乳腺癌、宫颈癌和结直肠癌筛查数据，以及人乳头瘤病毒（HPV）疫苗接种状况。将其与同一时间段内所有急诊科患者的电子健康记录（EHR）数据提取结果进行比较。主要结局是每组中癌症筛查和HPV疫苗接种未达标的比例。
对101人进行了急诊科调查；提取了2934名患者的EHR数据。调查结果与EHR数据相比，宫颈癌筛查未达标的比例分别为6.2%和77.6%，乳腺癌筛查为14.3%和73.4%，结直肠癌筛查为22.9%和56.5%，HPV疫苗接种为33.3%和57.8%。调查与EHR在所有筛查类别比较中的P值均<0.001。
我们的数据表明自我报告的筛查史与EHR数据之间存在显著差异。急诊科调查结果更符合各种监测系统中观察到的筛查率，并在文献中有所发表。这表明在急诊科进行即时调查管理可能在识别需要预防性癌症筛查的人群方面更有效，尤其是在常规医疗保健可及性较低的个体中。
