title: Improving anal cancer screening in an ambulatory HIV clinic: experience from a quality improvement initiative.
abstract: Evidence suggests that persons living with HIV (PLWH) are at increased risk for anal cancer. Early detection of anal cancer is an important prevention measure, but screening rates have been low. This report describes the experience of a quality improvement initiative to increase anal cancer screening at an HIV-specialty clinic. Chart reviews were conducted for three time periods: baseline year, prior to program discussion; transition year, during planning; and implementation year, during program availability. Odds ratios using Fisher's exact test showed that the odds of receiving anal cancer screening increased significantly in the transition year, odds ratio (OR) = 2.859, 95% confidence interval (CI): [1.798; 4.546], Fisher's z = 4.40, p < 0.0001, and in the implementation year, OR = 7.446, 95% CI: [4.783; 11.588], Fisher's z > 8.2, p < 0.0001. Patients and clinicians reported high levels of satisfaction with the program. Referring clinicians were also more likely to discuss anal cancer screening.
authors.affiliation: Division of Infectious Diseases, University of Colorado, Aurora, 80045, USA. JeffreyJKwong@gmail.com
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Kwong
authors.forename: Paul
authors.initials: P
authors.lastname: Cook
authors.forename: Lucy
authors.initials: L
authors.lastname: Bradley-Springer
mesh_terms: D000554:Ambulatory Care Facilities; D001005:Anus Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D016001:Confidence Intervals; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000517:prevention & control; D006801:Humans; D008297:Male; D016017:Odds Ratio; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D015397:Program Evaluation; D058996:Quality Improvement; D012307:Risk Factors