Cancer Screening Utilization Rates and Cancer Screening Perspectives of Hospitalized Women

Breast and colon cancers are commonly diagnosed cancers among women after skin cancer in Maryland. Patients' preferences for cancer screening are known to significantly influence utilization, and thus impact health outcomes. In a recent study the investigators conducted at Johns Hopkins Bayview Medical Center, the investigators observed that among women age 50-75 years admitted to general medicine services over 4-month period, 40% were non-adherent to breast cancer screening (overdue) despite being insured.

Therefore, the investigators propose to establish a cohort of hospitalized women to help the investigators develop successful interventions for enhancing breast cancer screening utilization in this group. In following a cohort prospectively, the investigators intend to both reaffirm the results from the investigators' previous study and determine whether the patterns of mammographic screening improve over time as a result of the investigators' interventions. Among non-adherent (overdue) women, the investigators will educate and encourage these women to undergo outpatient screening mammography.

To more comprehensively assess the preventive health in this cohort, the investigators will assess the cohort's adherence to colon cancer screening recommendation and barriers to colon cancer screening.

In addition the investigators will also like to encourage the hospitalists and house staff taking care of these patients to perform oral cancer screen among women who smoke (non-adherent to breast cancer screening) Finally the investigators will also like to ask the perspective of cancer screening among these women.

Study Overview

• Status: Completed
• Conditions: Cancer Screening
• Intervention / Treatment: Behavioral: Cancer screening education for breast, colon and oral cancers

• Study Type: Interventional
• Enrollment (Actual): 700
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Women between the ages of 50 to 75 years admitted to medicine service at Johns Hopkins Bayview Medical Center
• cancer free at baseline (excluding skin cancers)
• willing to participate voluntarily

Exclusion Criteria:

• history of breast cancer or mastectomy
• history of other cancers (except skin) or serious comorbidities making life expectancy <10 years
• pregnancy
• dementia
• chronic disability (unable to stand or nursing home resident)
• current admission because of acute coronary event (heart attack) or stroke or pulmonary embolism
• chronic kidney disease on hemodialysis
• history of BRCA1 or BRCA2 gene mutation
• current admission for cellulitis or abscess of breast

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cancer screening cohort; All women in this study to be evaluated for cancer screening utilization rates (breast, colon and oral cancers) and cancer screening perspectives of these hospitalized women. The intervention will be a cancer screening education.	Behavioral: Cancer screening education for breast, colon and oral cancers; Bedside education one-on-one by showing screening video and handouts at the end of educational session for breast, colon and oral cancer. Patient who are agreeable to oral cancer screen during hospitalization perform oral cancer screening

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of women non-adherent to breast cancer screening in this group	Proportion of women non-adherent to breast cancer screening will be assessed in these hospitalized women.	3 years
Prevalence of breast cancer screening post intervention in this group	Prevalence of breast cancer screening post intervention will be assessed in these hospitalized women.	3 years
Proportion of hospitalized women non-adherent to colon cancer screening	Proportion of hospitalized women non-adherent to colon cancer screening will be assessed in these hospitalized women.	3 years
Perspective of hospitalized women about colon cancer screening as assessed by multiple choice questions	survey of hospitalized women using multiple choice 21 questions	3 years
Perspective of hospitalized women about colon cancer screening as assessed by likert scale 21 questions	survey of hospitalized women using likert scale 21 questions	3 years
Proportion of women non-adherent to oral cancer screening	Proportion of women non-adherent to oral cancer screening will be assessed in these hospitalized women.	3 years
Number of women agreeable to inpatient oral cancer screening exam	oral cavity screening exam consisting of mouth and neck examination by hospital providers	3 years
Perspective of hospitalized women in general about their preference for cancers screening as assessed by multiple choice questions	a survey consisting of 55 multiple choice questions	3 years
Perspective of hospitalized women in general about their preference for cancers screening as assessed by likert scale	a survey with a likert scale	3 years

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: State of Maryland
• Investigators: Principal Investigator: Waseem Khaliq, MD, Johns Hopkins University

Publications and helpful links

General Publications

• Olayinka O, Gnanaraj J, Khaliq W. Hospitalized Women's Willingness to Pay for Inpatient Screening Colonoscopy. Womens Health Rep (New Rochelle). 2022 Sep 13;3(1):768-773. doi: 10.1089/whr.2022.0014. eCollection 2022.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2014
• Primary Completion (Actual): December 1, 2017
• Study Completion (Actual): December 1, 2022

Study Registration Dates

• First Submitted: November 12, 2019
• First Submitted That Met QC Criteria: November 12, 2019
• First Posted (Actual): November 14, 2019

Study Record Updates

• Last Update Posted (Estimate): December 8, 2022
• Last Update Submitted That Met QC Criteria: December 7, 2022
• Last Verified: December 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: IRB00049608; IO90059879 (Other Grant/Funding Number: State of Maryland)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No