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Improving cervical cancer screening in hospital settings
1Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland 21205, USA. aklassen@jhsph.edu
Preventive Medicine
|November 10, 2000
Summary
Maryland hospitals have screening policies, but many providers do not assess clinical need for Pap tests during admissions. Enhancing screening with clinical assessment and education can improve early cervical cancer detection in underscreened women.
Area of Science:
- Public Health
- Gynecology
- Health Services Research
Background:
- Cervical cancer screening is crucial for early detection, especially among underscreened populations.
- Maryland law mandates offering Pap tests during hospital admissions.
- This study investigates inpatient screening practices to improve effectiveness.
Purpose of the Study:
- To examine organizational and physician attitudes and practices regarding inpatient cervical cancer screening.
- To identify barriers and facilitators to increasing the effectiveness of Maryland's inpatient Pap test law.
Main Methods:
- Analysis of state admission data.
- Telephone survey of hospital administrators.
- Mailed survey of Maryland primary and specialty care physicians.
Main Results:
- Hospitals have policies and procedures for screening, with general concern for cancer.
- Most providers offered screening without assessing clinical need or providing persuasive recommendations.
- Subspecialists, non-primary care providers, and those serving African-American and Medical Assistance women showed less engagement in screening.
Conclusions:
- Hospitals possess adequate infrastructure for preventive screening.
- Integrating clinical assessment and persuasive education can enhance screening impact.
- Improvements are needed to better serve underscreened inpatient populations.