Abstract
OBJECTIVE: To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity.
DESIGN: Controlled trial.
SETTING: Urban county teaching hospital.
PARTICIPANTS: Women aged 40 years and over attending appointements in several non-primary-care outpatient clinics.
INTERVENTIONS: Lay health advisers assessed the participants’ breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner.
MEASUREMENTS AND MAIN RESULTS: Screening rates at base-line and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group (p=.009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group (p=.02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group (p=.006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group (p=.002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women.
CONCLUSIONS: Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.
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This research was supported by a grant (R01-CA52994-02) from the National Cancer Institute, Dr. Margolis was supported by an American Cancer Society Clinical Oncology Career Development Award for Primary Care Physicians while this work was carried out.
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Margolis, K.L., Lurie, N., McGovern, P.G. et al. Increasing breast and cervical cancer screening in low-income women. J GEN INTERN MED 13, 515–521 (1998). https://doi.org/10.1046/j.1525-1497.1998.00161.x
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DOI: https://doi.org/10.1046/j.1525-1497.1998.00161.x