Enhancing Adherence to Cervical Cancer Screening Guidelines at a Student-Run Free Clinic

J Community Health. 2020 Feb;45(1):128-132. doi: 10.1007/s10900-019-00724-8.

Abstract

Women who lack health insurance have much lower rates of cervical cancer screening and higher rates of cervical cancer than insured women. The current screening rate for insured patients is 86.9%, while the rate for uninsured women is 68.2%. Student-run free clinics may help increase the rates of cervical cancer screening in uninsured women. As screening rates in this setting are uncertain, this study was performed to determine rates of cervical cancer screening at a student-run free clinic, and therefore determine its effectiveness in increasing screening rates in uninsured women. A retrospective chart review was conducted among female patients ages 21-64 at a student-run free clinic to determine how many patients were up-to-date with cervical cancer screening per American Cancer Society (ACS) guidelines. A total of 239 women were included in the retrospective chart review. At their most recent visit, 87.9% of clinic patients were up-to-date on cervical cancer screening. This screening rate is higher than both the reported uninsured (68.2%) and insured (86.9%) national screening rates in the United States. Although there are multiple barriers that prevent uninsured patients from undergoing cervical cancer screenings, screening rates at our student-run free clinic are higher than national screening rates. This higher screening rate can be attributed to a standardized screening system, access to resources including Pap tests provided by community partners, and the clinic's ability to longitudinally follow patients. However, there remain areas for improvement, such as reducing no-show rates and ensuring that staff screen for cervical cancer at each visit.

Keywords: Cervical cancer screening; Pap smear; Student-run free clinic; Uninsured.

MeSH terms

  • Adult
  • Ambulatory Care Facilities / standards*
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Guideline Adherence*
  • Humans
  • Medically Uninsured
  • Middle Aged
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Student Run Clinic / standards*
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / therapy
  • Young Adult