Increasing Uptake of Cervical Cancer Screening: An Improvement Project

BACKGROUND: Cervical cancer is the fourth most common cancer in female patients worldwide. When cervical cancer is found in the early stages, the five-year survival rate is 91%. However, if it is not found until it reaches distal organs and tissues, the survival rate drops to 19%. Patient navigation programs are evidence-based ways to increase the uptake of recommended cancer screening.

LOCAL PROBLEM: The project took place in a mobile clinic serving uninsured patients in East Tennessee. The clinic utilizes both in-person and telehealth visits. Before implementation, the cervical cancer screening rate was 45%. The staff and administration of the mobile clinic identified cervical cancer screening as an area of improvement for their patient population. This project aimed to increase cervical cancer screening rates to 60% using a patient navigation program.

METHODS: The project used the Institute for Healthcare Improvement (IHI) Model for Improvement as the framework. This model utilizes PDSA cycles to make small, measurable changes to the intervention. To evaluate the change in screening rate, the pre-intervention percentage of cervical cancer screening was compared to the post-intervention percentage.

INTERVENTIONS: Female patients between the ages of 21 and 65 were given an educational cervical cancer screening infographic. Patients were assessed for screening need using a screening form available in English, Spanish, and Vietnamese.

RESULTS: 110 women were assessed for cervical cancer screening needs. Of those eligible for screening, 20% opted to screen the same day or scheduled an appointment. Post-intervention screening rate was 56.25%. Appointments continued to be scheduled post-implementation, suggesting a likely rise in screening uptake percentage.

CONCLUSIONS: This patient navigation program had a clinically significant impact on increasing the uptake of cervical cancer screenings. Improved screening rates will help with early detection and positive patient outcomes.