The COVID-19 pandemic has dramatically changed how outpatient primary care is delivered. Many important screenings – including screenings for multiple cancers – have been rapidly adapted to reduce the need for in-person clinic visits, with patients now able to conduct some cancer screenings at home.
To date, however, very little work has focused on patients’ acceptance of both home-based colorectal and cervical cancer screenings.
A new study from the Department of Family Medicine at the University of Michigan gathered patient opinions on at-home cancer screenings. Results of their pilot study were recently published in a paper titled, “Patient-Centered Home Screening Attitudes During COVID-19 Pandemic” in the October edition of the Journal of Patient Centered Research and Reviews.
The study’s first author is Christelle El Khoury, M.D., a member of the research team led by Diane Harper, M.D., MPH, MS, professor of family medicine and obstetrics and gynecology. Dr. Harper headed up this particular study.
The study team also included the cooperation of 10 additional family medicine department members to conduct research and compile data.
The team found that 60% of men and women preferred at-home colorectal cancer (CRC) screening when given the option. Additionally, the majority of female participants considered at-home cervical cancer screenings acceptable – something the researchers consider a “huge advance.”
“Often, non-invasive tests that are associated with fewer complications seem more appealing to patients and this may also have a major impact on the cost” of conducting these tests, said co-author Manasi Ramakrishnan, M.D., who is also the medical director of Michigan Medicine’s Dexter Health Center.
The researchers identified 879 potential participants by accessing electronic health records. A total of 132 individuals who had received care at Michigan Medicine agreed to complete the survey.
Participants were divided into three different categories – those who had been hospitalized with COVID-19 and survived; those with type 2 diabetes; and those with an acute upper respiratory disease unrelated to COVID. These groupings allowed researchers to analyze patient perspectives from individuals receiving care for a wide variety of conditions across the continuum of care.
Among women surveyed, urine and vaginal screening for human papillomavirus (HPV), which can cause cervical cancer, was acceptable to 64% and 59% of respondents, respectively. At-home colorectal cancer screening through fecal sampling was acceptable to 60% of respondents, both men and women.
Women with positive attitudes toward home-based urine cervical cancer screening were 49 times more likely to screen with home-based fecal CRC screening. Those who had positive attitudes towards vaginal cervical cancer screening were 23 times more likely to screen with home-based fecal CRC screening.
“These findings indicate that home-based cancer screens for CRC and primary HPV testing are acceptable to men and women and may allow for greater compliance with screening in the future,” the authors write.
They add that family physicians are ‘well placed’ to help patients weigh the benefits and potential risks of various screening options to find the best option for them individually.
“Based on this evidence, we should start thinking about addressing cancer screening in a different way, perhaps ways that are more approachable to patients,” said Assistant Professor Nicoll Capizzano, M.D., who was part of the study. “More research is needed to be done about home-based screening, specifically in colon and cervical cancer screening."
The team’s paper can be accessed here.
Article Citation: El Khoury C, Haro E, Alves M, O'Dwyer MC, Meixner K, Albiac LC, Capizzano JN, Ramakrishnan M, Salada C, Sheinfeld Gorin S, Jimbo M, Sen A, Harper DM. Patient-centered home cancer screening attitudes during COVID-19 pandemic. J Patient Cent Res Rev. 2021;8:340-6. doi: 10.17294/2330-0698.1835