Improving cervical cancer screening in hospital settings

Background: Identifying opportunities to offer cervical cancer screening to underscreened women is important for increasing early detection. Maryland law mandates offering Pap tests during hospital admissions. We examined org anizational and physician attitudes and practices regarding inpatient scree ning, to identify mechanisms for increasing the law's effectiveness. Methods: We analyzed state admission data, a hospital administrators teleph one survey, and a mailed survey of Maryland primary and specialty care phys icians, to identify overall patterns and subgroup differences regarding scr eening. Results: Overall, we found significant concern regarding cancer, and eviden ce of policies and procedures for screening. However, most hospitals and pr oviders offered screening without assessing clinical need or including pers uasive recommendations. Providers with significantly less engagement in pre ventive assessment and screening included medical and surgical subspecialis ts and non-primary care providers. Providers to African-American and Medica l Assistance women were also less likely to have knowledge, attitudes, and practices conducive to inpatient screening. Conclusions: Adequate support and infrastructure for preventive screening e xist within hospitals. Adding clinical assessment and persuasive education could increase the impact of these mechanisms, and improve prevention among underscreened inpatient populations, (C) 2000 American Health Foundation a nd Academic Press.