Improving Cervical Cancer Screening Rates and Utilization of Evidence-Based Treatment Guidelines at a Rural Primary Care Clinic

Ugwuegbulam, Ugochi
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Cancer is the second leading cause of death in the United States, exceeded only by heart disease; one of every four deaths in the United States is due to cancer (Center for Disease Control and Prevention, 2018). Cervical cancer is the fourth most common cancer in women, leading to an estimated 528,000 cases and 266,000 deaths worldwide in 2012(Campos et al., 2016). Cervical cancer screening through the Papanicolaou (Pap) test is an effective means of detecting precancerous cell changes within the transformational zone of the cervix and reducing the incidence of cervical cancer in the asymptomatic stage (Everett et al., 2014).

Purpose & Objective: This quality improvement project is intended to increase the rate of cervical cancer screening by introducing a home human papilloma virus (HPV) testing option with increased patient education and to standardize the utilization of the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) guideline in a primary care setting.

Method: Evidence-based interventions implemented included providing an option for home HPV testing with augmented teaching and a workflow change to ensure ASCCP guidelines are followed to manage abnormal results. Data analyses were done utilizing a run chart, descriptive statistics, and a Chi-square test to analyze changes in pre-and postintervention outcomes.

Result: Findings showed a 46% increase in post-project cervical cancer screening rates at the facility compared to the preintervention phase of the project. Increased providers’ adherence to ASCCP guidelines in managing abnormal cervical cancer screening result noted postintervention.

Cervical cancer screening, Early detection, Cancer guidelines, HPV self-test, Cancer prevention