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Identifying Barriers to Cancer Screening Numbers in a Family Practice Clinic in Rural Nebraska
Abstract
ABSTRACT
Background/ Purpose: Cancer remains a leading cause of death throughout the world. According to the CDC, cancer related death rates in rural areas remain higher at a rate of 180 compared to 158 deaths per 100,000 persons in urban communities. Literature review suggests there are a multitude of methods to increase patient screening for breast and colorectal cancer (CRC). The purpose of this quality improvement project is to identify barriers to cancer screenings within a rural family practice clinic.Design/ Methods: Project methods included provider and healthcare team education related to current breast and colorectal screening recommendations and methods, patient education via informative handout as well as discussion regarding past due cancer screenings, and a written patient reminder card for those who refused current screening recommendations.Findings/ Results: A total of 26 patients presented for wellness or chronic care visits during the implementation period and were offered breast and/ or CRC screening. Of the 26 patients, 8 agreed to complete screening, 3 initially refused but agreed after additional education, and 15 refused despite additional education. Barriers for completing screening included cost, inability to carry out facility-mandated COVID-19 isolation prior to procedure, patient perception of healthy status with screening deemed unnecessary by patient, and postponement due to work.Conclusions/ Implications to Practice: Rural populations are at risk for increased late stage cancer diagnosis due to low screening numbers. Education provided was 11% effective to increase cancer screening agreement. Further research and public health implications could seek to create methods that address project identified barriers with goal of increasing screening numbers. Examples include need for financial resources and additional education for patients feeling screening is unnecessary due to current health status.
Background/ Purpose: Cancer remains a leading cause of death throughout the world. According to the CDC, cancer related death rates in rural areas remain higher at a rate of 180 compared to 158 deaths per 100,000 persons in urban communities. Literature review suggests there are a multitude of methods to increase patient screening for breast and colorectal cancer (CRC). The purpose of this quality improvement project is to identify barriers to cancer screenings within a rural family practice clinic.Design/ Methods: Project methods included provider and healthcare team education related to current breast and colorectal screening recommendations and methods, patient education via informative handout as well as discussion regarding past due cancer screenings, and a written patient reminder card for those who refused current screening recommendations.Findings/ Results: A total of 26 patients presented for wellness or chronic care visits during the implementation period and were offered breast and/ or CRC screening. Of the 26 patients, 8 agreed to complete screening, 3 initially refused but agreed after additional education, and 15 refused despite additional education. Barriers for completing screening included cost, inability to carry out facility-mandated COVID-19 isolation prior to procedure, patient perception of healthy status with screening deemed unnecessary by patient, and postponement due to work.Conclusions/ Implications to Practice: Rural populations are at risk for increased late stage cancer diagnosis due to low screening numbers. Education provided was 11% effective to increase cancer screening agreement. Further research and public health implications could seek to create methods that address project identified barriers with goal of increasing screening numbers. Examples include need for financial resources and additional education for patients feeling screening is unnecessary due to current health status.