Cervical cancer screening in the urgent care setting.
OBJECTIVE
To determine the feasibility of cervical cancer screening in an urgent care clinic.


METHODS
Prospective randomized trial.


METHODS
Public teaching hospital.


METHODS
Women presenting to the urgent care clinic whose evaluation necessitated a pelvic examination were eligible for participation. Women who had a hysterectomy, had a documented Pap test at our institution in the past year, did not speak English or Spanish, or had significant vaginal bleeding were excluded. Women presenting to the gynecology clinic for a scheduled Pap test were used as a comparison group for rates of follow-up, Pap smear adequacy, and Pap smear abnormalities.


METHODS
Women randomized to the intervention group had a Pap test performed as part of their pelvic examination, while women in the usual care group were encouraged to schedule an appointment in the gynecology clinic at a later date. The women in the two groups completed identical questionnaires regarding cervical cancer risk factors and demographic information.


RESULTS
Ninety-four (84.7%) of 111 women in the intervention group received a Pap test, as compared with 25 (29%) of 86 in the usual care group (P <.01). However, only 5 (24%) of 21 women with abnormal Pap smears in the intervention group received follow-up compared with 6 (60%) of 10 women seen during the same time period in the gynecology clinic for self-referred, routine annual examinations (P =.11). Pap smears obtained in the urgent care clinic were similar to those in the gynecology clinic with regard to abnormality rate (22.3% vs 20%; P =.75, respectively) and specimen adequacy (67% vs 72%; P =.54, respectively).


CONCLUSIONS
Urgent care clinic visits can be used as opportunities to perform Pap test screening in women who are unlikely to adhere to cervical cancer screening recommendations. However, to accrue the full potential benefit from this intervention, an improved process to ensure patient follow-up must be developed.
Batal
H
H
Urgent Care Clinic at Denver Health and Department of Medicine at the University of Colorado Health Sciences Center, Denver 80204, USA. hbatal@dhha.org
Biggerstaff
S
S
Dunn
T
T
Mehler
P S
PS
D000293:Adolescent; D000328:Adult; D000368:Aged; D003120:Colorado; D004638:Emergency Treatment; D005240:Feasibility Studies; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*