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Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population
INTRODUCTION: A suspected diagnosis of cancer through an emergency department (ED) visit is associated with poor clinical outcomes. The purpose of this study was to explore the rate at which ED patients attend cancer screenings for lung, colorectal (CRC), and breast cancers based on national guideli...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine School of Medicine
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541977/ https://www.ncbi.nlm.nih.gov/pubmed/36205665 http://dx.doi.org/10.5811/westjem.2022.5.55351 |
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author | Pettit, Nicholas Ceppa, DuyKhanh Monahan, Patrick |
author_facet | Pettit, Nicholas Ceppa, DuyKhanh Monahan, Patrick |
author_sort | Pettit, Nicholas |
collection | PubMed |
description | INTRODUCTION: A suspected diagnosis of cancer through an emergency department (ED) visit is associated with poor clinical outcomes. The purpose of this study was to explore the rate at which ED patients attend cancer screenings for lung, colorectal (CRC), and breast cancers based on national guidelines set forth by the United States Preventive Services Task Force (USPSTF). METHODS: This was a prospective cohort study. Patients were randomly approached in the Eskenazi Hospital ED between August 2019–February 2020 and were surveyed to determine whether they would be eligible and had attended lung, CRC, and breast cancer screenings, as well as their awareness of lung cancer screening with low-dose computed tomography (LDCT). Patients who were English-speaking and ≥18 years old, and who were not critically ill or intoxicated or being seen for acute decompensated psychiatric illness were offered enrollment. Enrolled subjects were surveyed to determine eligibility for lung, colorectal, and breast cancer screenings based on guidelines set by the USPSTF. No cancer screenings were actually done during the ED visit. RESULTS: A total of 500 patients were enrolled in this study. More participants were female (54.4%), and a majority were Black (53.0%). Most participants had both insurance (80.2%) and access to primary care (62.8%). Among the entire cohort, 63.0% identified as smokers, and 62.2% (140/225) of the 50- to 80-year-old participants qualified for lung cancer screening. No patients were screened for lung cancer in this cohort (0/225). Only 0.6% (3/500) were aware that LDCT was the preferred method for screening. Based on pack years, 35.5% (32/90) of the patients who were 40–49 years old and 6.7% (6/90) of those 30–39 years old would eventually qualify for screening. Regarding CRC screening, 43.6% (218/500) of the entire cohort was eligible. However, of those patients only 54% (118/218) had been screened. Comparatively, 77.7% (87/112) of the eligible females had been screened for breast cancer, but only 54.5% (61/112) had been screened in the prior two years. CONCLUSION: Many ED patients are not screened for lung/colorectal/breast cancers even though many are eligible and have reported access to primary care. This study demonstrates an opportunity and a need to address cancer screening in the ED. |
format | Online Article Text |
id | pubmed-9541977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Department of Emergency Medicine, University of California, Irvine School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-95419772022-10-11 Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population Pettit, Nicholas Ceppa, DuyKhanh Monahan, Patrick West J Emerg Med Health Outcomes INTRODUCTION: A suspected diagnosis of cancer through an emergency department (ED) visit is associated with poor clinical outcomes. The purpose of this study was to explore the rate at which ED patients attend cancer screenings for lung, colorectal (CRC), and breast cancers based on national guidelines set forth by the United States Preventive Services Task Force (USPSTF). METHODS: This was a prospective cohort study. Patients were randomly approached in the Eskenazi Hospital ED between August 2019–February 2020 and were surveyed to determine whether they would be eligible and had attended lung, CRC, and breast cancer screenings, as well as their awareness of lung cancer screening with low-dose computed tomography (LDCT). Patients who were English-speaking and ≥18 years old, and who were not critically ill or intoxicated or being seen for acute decompensated psychiatric illness were offered enrollment. Enrolled subjects were surveyed to determine eligibility for lung, colorectal, and breast cancer screenings based on guidelines set by the USPSTF. No cancer screenings were actually done during the ED visit. RESULTS: A total of 500 patients were enrolled in this study. More participants were female (54.4%), and a majority were Black (53.0%). Most participants had both insurance (80.2%) and access to primary care (62.8%). Among the entire cohort, 63.0% identified as smokers, and 62.2% (140/225) of the 50- to 80-year-old participants qualified for lung cancer screening. No patients were screened for lung cancer in this cohort (0/225). Only 0.6% (3/500) were aware that LDCT was the preferred method for screening. Based on pack years, 35.5% (32/90) of the patients who were 40–49 years old and 6.7% (6/90) of those 30–39 years old would eventually qualify for screening. Regarding CRC screening, 43.6% (218/500) of the entire cohort was eligible. However, of those patients only 54% (118/218) had been screened. Comparatively, 77.7% (87/112) of the eligible females had been screened for breast cancer, but only 54.5% (61/112) had been screened in the prior two years. CONCLUSION: Many ED patients are not screened for lung/colorectal/breast cancers even though many are eligible and have reported access to primary care. This study demonstrates an opportunity and a need to address cancer screening in the ED. Department of Emergency Medicine, University of California, Irvine School of Medicine 2022-09 2022-08-11 /pmc/articles/PMC9541977/ /pubmed/36205665 http://dx.doi.org/10.5811/westjem.2022.5.55351 Text en Copyright: © 2022 Pettit et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Health Outcomes Pettit, Nicholas Ceppa, DuyKhanh Monahan, Patrick Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title | Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title_full | Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title_fullStr | Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title_full_unstemmed | Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title_short | Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population |
title_sort | low rates of lung and colorectal cancer screening uptake among a safety-net emergency department population |
topic | Health Outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541977/ https://www.ncbi.nlm.nih.gov/pubmed/36205665 http://dx.doi.org/10.5811/westjem.2022.5.55351 |
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