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Papanicolaou screening in an urgent care setting. | LitMetric

Papanicolaou screening in an urgent care setting.

Am J Obstet Gynecol

Denver Health Medical Center, 777 Bannock St, Denver, CO 80204, USA.

Published: April 2005

AI Article Synopsis

  • - The study assessed the effectiveness of Pap screenings in an urgent care setting and compared cervical intraepithelial neoplasia (CIN) rates and follow-up between patients who had and didn't have primary care.
  • - A total of 673 Pap smears were performed, with 660 analyzed, finding that 59.4% of patients had never had a Pap before, and the follow-up rate for abnormal results was 56%.
  • - Results showed that patients receiving care only through urgent care had similar CIN rates and follow-up as those with established primary care, indicating that urgent care can effectively handle Pap screenings.

Article Abstract

Objective: This study was undertaken to determine the efficacy of Papanicolaou (Pap) screening in an urgent care setting, and to compare the rates of cervical intraepithelial neoplasia (CIN), and follow-up in patients with and without established primary care.

Study Design: All patients presenting with a complaint warranting pelvic examination between December 2000 and September 2001 underwent Pap screening. All patients were scheduled an appointment or follow-up visit when an abnormal Pap test was found. Charts were reviewed for cytologic interpretation, age, chief complaint, ethnicity, history of prior Pap smear in the institution, total visit history (includes urgent care and primary care clinics). SAS 8.1 was used for statistical analysis with the use of the Fisher exact test.

Results: A total of 673 Pap smears were performed. Of those, 660 were analyzed and 13 were discarded because of inadequate slides. The mean age was 29.6 years; the ethnic distribution was 0.2% Native American, 1.2% Asian, 17% black, 62.4% Hispanic, 18.2% white, and 1.1% other. In the study population, only 40.6% of the patients had a prior Pap screen and 59.4% had not. There were 318 (48.2%) patients who had accessed care only through the urgent care clinic, and 342 (51.8%) patients who had established some kind of primary care in the past. The overall follow-up rate was 56% for any abnormal Pap smear, regardless of visit history.

Conclusion: Patients accessing medical care through an urgent care clinic exclusively had identical rates of CIN and follow-up when compared with patients with established care. Therefore, when a system exists to centrally process and triage cervical cytology, it is efficacious to screen for CIN in an urgent care setting.

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Source
http://dx.doi.org/10.1016/j.ajog.2004.09.030DOI Listing

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