Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients

Abstract

BackgroundLack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1) Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2) Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them.MethodsEmergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models.ResultsOf 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were < age 35, white, single (never married and no partner), Catholic, and had private medical insurance. Participant's recent or current usage of a particular cancer screening or contraceptive method varied by type of method: Pap smear within the past year (69.1%), breast self-exam within the past month (45.5%), mammogram within the past year (65.7% for women age 45–55), condom usage during every episode of sexual intercourse (15.4%), current usage of birth control pills (17.8%), and ever use of emergency contraception (9.3%). The participants correctly answered 87.9% of all survey questions about condoms, 82.5% about birth control pills, 78.5% about breast self-exams, 52.9% about Pap smears, 35.4% about mammograms, and 25.0% about emergency contraception. In multivariable logistic regression models, survey participants who had private medical insurance and those who recently or currently used a given screening or contraceptive method had a greater odds of correctly answering all questions about each cancer screening or contraceptive method.ConclusionAlthough these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.

Improving Cancer Knowledge and Screening Awareness: Test of a Telephone Interviewer Intervention

“…Despite expenditures in the millions of dollars and national campaigns by the American Cancer Society, the National Cancer Institute, as well as the efforts of most hospitals and physicians, large segments of the population do not possess knowledge about when to obtain screening. [2][3][4] The challenge of how best to educate the public is compounded by lack of health literacy, 5 fear of procedures or what they may reveal, [6][7][8] and the deterrent cost of screening procedures for many individuals. 9 To make the issue even more complex, educational efforts may focus on very specific aspects of the population and need to appeal to individuals of a certain gender, age, or ethnic/cultural background.…”

Implementation of secondary preventive practice important for cervical cancer among women who use oral contraception

“…The study by Castellsagué and Muñoz has pointed out importance of secondary preventive measures for the cervical cancer in OC users (19). Some studies, unlike ours, have found out more frequent preventive measures application in the OC users (20)(21)(22). The study by Park SJ and Park WS have found to women under hormone therapy were significantly more likely to get Pap tests and check-ups (23).…”

Negative Opinions About Cancer Screening and Contraceptive Measures by Female Emergency Department Patients

“…The development of the questionnaire for this study has been reported previously (Merchant et al 2007); a summary is provided here. We created a draft version of the questionnaire after reviewing numerous questionnaires from published women’s cancer screening and contraceptive health studies.…”

“…Elsewhere, we have reported our findings on these patients’ cancer screening and contraceptive knowledge (Merchant et al 2007) and preferences for women’s cancer screening and contraceptive services (Merchant et al 2007). In this manuscript, we report on a potential barrier to the successful implementation of women’s cancer screening and contraceptive programs in EDs: negative opinions by women toward Pap smears, BSEs, BCPs, and condoms.…”