Screening For Early Detection Research Articles

Examining School Nurses' Knowledge and Confidence Related to Their Intention to Screen for and Report Child Sexual Abuse: A Descriptive Cross-Sectional Study.

Child sexual abuse (CSA) is a preventable national public health problem that results in adverse health consequences. Research suggests youth experiencing CSA are often of school age. Screening for early detection of health issues is integral to school nurse (SN) practice. Still, there is little evidence that routine screening when CSA is suspected is occurring in schools, despite recommendations that it should be. Lack of confidence and knowledge related to screening and reporting for CSA contribute to a SN's missed opportunity for early intervention. The aim of this study was to describe SNs' knowledge and self-efficacy associated with screening for and reporting suspected CSA in school settings. A descriptive cross-sectional survey design was employed. The Child Abuse Report Intention Scale was sent to over 2,000 members of the National Association of School Nurses. Among SN respondents (N = 123), the main findings showed almost half reported being concerned a youth was experiencing CSA but may have missed identifying it. Self-efficacy and professional responsibility were predictors of SNs' intention to screen as well as knowledge about obvious and serious signs of abuse were predictors of SNs' intention to report in this sample. An educational partnership between forensic nurse examiners and SNs can facilitate improving SNs' knowledge about nonspecific physical and behavioral indicators of abuse that are not overtly obvious. The development of a screening tool specific for use by SNs can empower their confidence to screen by providing a resource for them to use as a guide when they are uncertain about the evidence.

Disparities and Determinants of Testing for Early Detection of Cervical Cancer among Nepalese Women: Evidence from a Population-Based Survey.

Cervical cancer presents a considerable challenge in South Asia, notably in Nepal, where screening remains limited. Past research in Nepal lacked national representation and a thorough exploration of factors influencing cervical cancer screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of cervical cancer among Nepalese women. Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (World Health Organization STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30 to 69 years, were used. Respondents were asked if they had undergone cervical cancer testing through visual inspection with acetic acid, Pap smear, or human papillomavirus test ever or in the past 5 years. The slope index of inequality (SII) and relative concentration index were used to measure socioeconomic and education-based disparities in cervical cancer test uptake. Only 7.1% [95% confidence interval (CI): 5.1-9.9] Nepalese women had ever undergone cervical cancer testing, whereas 5.1% (95% CI: 3.4-7.5) tested within the last 5 years. The ever uptake of cervical cancer testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from the richest compared with the poorest households. Education-based disparities were particularly pronounced, with a 13.9 percentage point difference between highly educated urban residents and their uneducated counterparts (SII: 13.9, 95% CI: 5.8-21.9). Less than one in ten women in Nepal had a cervical cancer testing, primarily favoring higher educated and wealthier individuals. Targeted early detection and cervical cancer screening interventions are necessary to address these disparities and improve access and uptake.

Maternal factors associated with the occurrence of Low Birth Weight (LBW) Infants at the Haji Hospital, East Java Province

Introduction: Low birth weight infants are an indicator of public health problems. They are also included in the 100 core health conditions the World Health Organization (WHO) compiled. LBW Infants are still the cause of infant mortality in Indonesia. The infant mortality rate in Indonesia is still not reaching the SDGS target. Objective: This study aims to examine maternal factors associated with the occurrence of LBW Infants at the Haji Hospital, East Java Province Method: This study used a retrospective method with a case-control study design. This study took a sample of 258 infants with inclusion and exclusion criteria. Data collection uses secondary data in the form of collection carried out in the delivery and medical records room. Result: Bivariate analysis obtained the results of gestational age (p < 0.001), history of LBW infants (p = 0.03), anemia (p = 0.641), hypertension in pregnancy (p < 0.001), maternal illness (p < 0.001) with the occurrence of LBW infants. Based on multivariate analysis, mothers with gestational age <37 weeks had OR 8.667 (95%CI 4.509-16.659), a history of LBW infant had OR 10.736 (95%CI 1.895-60.809), hypertension in pregnancy OR 2.468 (95%CI 1.250-4.869), and maternal illness OR 3.212 (95%CI 1.301-7.932) times to experience LBW infants. Conclusion: This study highlights the burden of caring for LBW infants in the Haji Hospital in East Java province. Maternal factors need to be given special attention during pregnancy. Health promotion measures, early detection screening, and intervention of related factors need to be done so that the occurrence of LBW infants can be prevented.

Pap Cytology and Human Papillomavirus (HPV) Genotypes in Western Romania: A Retrospective Analysis.

Background and objective Vigorous proactive measures are needed to combat cervical cancer, linked to the human papillomavirus (HPV). HPV genotyping aids in identifying high-risk strains, enabling targeted screening and risk assessment. This informs treatment decisions, reducing cervical cancer cases. In light of this, we conducted aretrospective analysis of Pap cytology and HPV genotypes to assess western Romania's new screening program. Understanding HPV prevalence, genotype correlations, and risk factors will help refine risk stratification models and enhance public health strategies. Methodology This retrospective studyanalyzed Pap smears from 195 patients with a mean age of 40 years [standard deviation (SD): 12 years], with a peak of incidence between 25 and 30 years. The patient cohort, with equal representationfrom urban and rural areas, comprised sexually active women of reproductive age presenting to the Gynaecology Ambulatory of the Municipal Emergency Clinical Hospital Timișoara over two years. Patients not sexually active and those in menopause were excluded. HPV genotyping was done on 67 patients. Data were analyzed using JASP, employing descriptive statistics, frequency tables, contingency tables, chi-squared test, odds ratio, and Fisher's exact test. Results Among 195 patients undergoing Pap smear tests, the most prevalent finding was negative (77.95%), indicating no abnormal cells detected. A smaller proportion of patients exhibited low-grade squamous intraepithelial lesions (LSIL, 11.28%) or atypical squamous cells of undetermined significance (ASC-US, 8.72%) findings. High-grade lesions (HSIL, ASC-H) were rare. For cytology grading, Category II (CII) was the most prevalent (75.90%), followed by Category III (CIII, 24.10%). HPV genotyping was performed on a subset of patients (n=67). Among them, Type 16 was the most frequent (28.36%), followed by Other high-risk types(20.89%), Type 16 (28.35%), and Type 18 (13.43%). HPV testing was not performed for 65.64% of the patients. Overall, the study suggests that a significant majority of the patients had normal Pap smears. However, a small proportion did have abnormal findings, including HPV infection. These findings highlight the importance of Pap smear screening for early detection of cervical abnormalities. Conclusions Our study from western Romania highlights the importance of HPV testing and Pap cytology in cervical cancer prevention. HPV testing is a potent tool for identifying high-risk women, and when combined with Pap cytology, it provides a more comprehensive screening strategy. Our research also revealed a diverse HPV genotype distribution, suggesting the need for broader-spectrum vaccines like the nonavalent vaccine. Despite our study's limitations, our findings underscore the need for including HPV testing in national screening guidelines. Future research should focus on larger studies and the cost-effectiveness of broader-spectrum vaccines. Implementing policies based onthese findings could lead to more effective cervical cancer prevention in western Romania.

Potential diagnostic, prognostic, and predictive biomarkers of gastric cancer.

Gastric cancer (GC), a malignant epithelial tumor, is the fourth leading cause of cancer-related death worldwide. Therapeutic strategies for GC, despite the biggest challenges, can significantly improve survival rates through early detection and effective screening methods. To provide brief information on the necessity of multiple specific diagnostic, prognostic, and predictive markers for GC. This review was conducted using a variety of search engines, including PubMed Central, Scopus, Web of Science, Google Scholar, and others. Some potential biomarkers that provide essential information include circulating tumor cells (CTCs), DNA methylation, claudin 18.2, fibroblast growth factor receptor 2 (FGFR2), long noncoding RNAs (lncRNAs), cell-free DNA (cfDNA), microRNAs, and serum pepsinogens. Multiple tumor markers are essential for screening, tumor identification, staging, prognostic assessment, and monitoring recurrence after therapy due to the absence of a single tumor indicator for diagnosing, prognosticating, and predicting GC.

Independent Community Empowerment Program to Address Non-Communicable Disease Problems in Coastal Areas of Pekanbaru City

The purpose of this community service is to make efforts to prevent the spread of non-communicable diseases. The formulation of the problem in this study is how to conduct early detection (screening) of health, how to increase the knowledge and ability of the Sri Meranti Village Community in overcoming non-communicable disease health problems, and how to empower the community in overcoming and preventing NCD problems that occur at home or in the neighborhood. The research method used is the prevention method by providing education related to what non-communicable diseases are and how to prevent them. The results obtained were an increase in community knowledge related to non-communicable diseases worth 31.41. It is hoped that this program, which has shown success, can be continued so that the number of non-communicable diseases can decrease in the community.

Assessment of the Knowledge of Retinopathy of Prematurity (ROP) in a Cohort of Nurses in Ogun State, Nigeria

Background: Retinopathy of prematurity (ROP) is a major cause of childhood blindness that can be prevented by early detection and treatment. Nurses and midwives are important stakeholders in neonatal services who can help increase awareness to ensure early detection, thereby reducing the risk of blindness. Objectives: To determine the knowledge of a cohort of nurses in Ogun state about ROP and ROP screening. Methods: A cross-sectional study was conducted among nurses and midwives in Ogun State, Nigeria. A self-administered structured Google form (questionnaire) was used to obtain information on their knowledge and practice concerning ROP in their centres. Results: A total of 117 nurses participated in the study. These comprised 93.2% females, and the mean age was 38.5±3.5years. The majority of the participants were within the 41-50 years age group. A total of 70.9% had ever worked in a neonatal unit. Ninety-seven (82.9%) were aware of ROP, of which 76.1% could correctly define the condition. Sixty-nine per cent had a good knowledge score for ROP, while there was a poor knowledge score for screening in 62.4%. Conclusion: Though the participants had good knowledge about ROP, their knowledge of screening for early detection was poor. There is a need for intense dissemination of information on ROP, especially the need for screening of newborn infants among nurses and midwives.

Efforts to enhance the awareness in significance of early detection for dental and oral diseases in the society 5.0

Oral health is an integral part of overall well-being that demands attention from every individual. Poor oral hygiene can lead to various oral diseases, including dental caries. This community service program aimed to enhance students' understanding of oral health, encourage regular dental checkups, and promote preventive measures against oral diseases through the utilization of various digital tools, including an early detection screening application. Health education sessions were conducted, incorporating pre- and post-tests to evaluate learning outcomes. Additionally, clinical examinations were carried out to assess students' oral health status. The results were encouraging, counseling and education sessions significantly increased knowledge and awareness in over half the participants (55%). However, clinical examinations revealed that a substantial portion (36 students) had unhealthy oral hygiene, highlighting the need for continuous education and preventive strategies.

Causal relationship between endometrial cancer and risk of breast cancer: A 2-sample Mendelian randomization study

Several studies have confirmed the important role of endometrial cancer (EC) in the development and progression of breast cancer (BC), and this study will explore the causal relationship between EC and BC by 2-sample Mendelian randomization analysis. Pooled data from published genome-wide association studies were used to assess the association between EC and BC risk in women using 5 methods, namely, inverse variance weighting (IVW), MR-Egger, weighted median (WME), simple multimaximetry (SM) and weighted multimaximetry (WM) with the EC-associated genetic loci as the instrumental variables (IV) and sensitivity analyses were used to assess the robustness of the results. The statistical results showed a causal association between EC and BC (IVW: OR = 1.07, 95% CI = 1.01–1.32, P = .02; MR-Egger: OR = 1.21, 95% CI = 0.71–1.51, P = .11; weighted median: OR = 1.05, 95% CI = 0.97–1.31, P = .19; simple plurality method: OR = 0.98, 95% CI = 0.81–1.15, P = .78; weighted plurality method: OR = 0.98, 95% CI = 0.81–1.14, P = .75), and the results of the sensitivity analyses showed that there was no significant heterogeneity or multiplicity, and the results were stable. EC is associated with an increased risk of developing BC. The results of this MR analysis can be used as a guideline for screening for BC in women with EC and to help raise awareness of screening for early detection and treatment.

Prospective cardiovascular events in patients with advanced thoracic cancer treated with immune checkpoint inhibitor

IntroductionMyocarditis is the most lethal cardiovascular immune related adverse events with a low incidence, depending on the studies. We prospectively studied the potential interest of a systematic screening to early detect immune related myocarditis and confirm the incidence of immune-induced myocarditis in advanced lung cancer and the impact of troponin systematic screening in early detection of other major cardiovascular events (MACE). Material and methodsThis prospective bicentric study includes adults who received at least one dose of immune checkpoint inhibitor (ICI) for advanced lung cancer. Cardiac biomarkers dosage, ECG and transthoracic echography (TTE) were done at baseline. Diagnosis of myocarditis was based on European Society of Cardiology recommendations. MACEs were reported during the observation period. ResultsAmong 298 patients, 5 (1.68 %) immune-induced myocarditis occurred, all being asymptomatic with at first troponin elevation, treated by corticosteroids and ICI’s discontinuation. No attributable death occurred, and no specific clinical characteristics were identified with myocarditis onset. Three patients were rechallenged with ICI after troponin normalization in the absence of other therapeutic options. Recurrence occurred in 2 patients, with a re-increase of troponin and a de novo modification of the ECG. Systematic cardiovascular screening also led to 14 cardiovascular diseases detection and 11 MACEs during ICI. ConclusionSystematic cardiovascular screening has uncovered slightly more immuno-induced myocarditis cases than reported previously, but without altering treatment strategies due to their subclinical nature. Additionally, it helps detecting other cardiovascular diseases in this comorbid population.

HES V2.0 outperforms GALAD for detection of HCC: A phase 3 biomarker study in the United States.

The original hepatocellular carcinoma early detection screening (HES) score, which combines alpha-fetoprotein (AFP) with age, alanine aminotransferase, and platelets, has better performance than AFP alone for early HCC detection. We have developed HES V2.0 by adding AFP-L3 and des-gamma-carboxy prothrombin to the score and compared its performance to GALAD and ASAP scores among patients with cirrhosis. We conducted a prospective-specimen collection, retrospective-blinded-evaluation phase 3 biomarker cohort study in patients with cirrhosis enrolled in imaging and AFP surveillance. True-positive rate (TPR)/sensitivity and false-positive rate for any or early HCC were calculated for GALAD, ASAP, and HES V2.0 scores within 6, 12, and 24 months of HCC diagnosis. We calculated the AUROC curve and estimated TPR based on an optimal threshold at a fixed false-positive rate of 10%. We analyzed 2331 patients, of whom 125 developed HCC (71% in the early stages). For any HCC, HES V2.0 had higher TPR than GALAD overall (+7.2%), at 6 months (+3.6%), at 12 months (+7.2%), and 24 months (+13.0%) before HCC diagnosis. HES V2.0 had higher TPR than ASAP for all time points (+5.9% to +12.0%). For early HCC, HES V2.0 had higher sensitivity/TPR than GALAD overall (+6.7%), at 12 months (+6.3%), and 24 months (+14.6%) but not at 6 months (+0.0%) and higher than ASAP for all time points (+13.4% to +18.0%). In a prospective cohort study, HES V2.0 had a significantly higher performance for identifying new HCC, including early stage, than GALAD or ASAP.

HPR75 Can Multi-Cancer Early Detection Screening Result in Early Cancer Detection? A Modeling Study

HPR75 Can Multi-Cancer Early Detection Screening Result in Early Cancer Detection? A Modeling Study

Perceptions of multi-cancer early detection (MCED) screening tests among underrepresented populations.

e22546 Background: Cancer is the second leading cause of death, with higher death rates observed among racial and ethnic minorities and individuals of lower income. MCED tests detect a shared cancer signal in plasma cell-free DNA. Beyond clinical/direct economic benefits, MCED may offer additional benefits (emotional, social, and/or behavioral) associated with a no cancer signal detected (NCSD) result, which might differ depending on socioeconomic status. This study aimed to explore the value of a NCSD result from the perspective of underrepresented individuals from the US general population. Methods: Qualitative interviews informed a cross-sectional online survey administered to adults aged 40-80 years without a cancer diagnosis within the last 5 years and not on cancer treatment. Soft quotas ensured a sample representative of the US population by age, gender, race, and ethnicity. The survey asked about the perceived value of a NCSD result from a hypothetical MCED test and collected sociodemographic and clinical information. Results were summarized descriptively. Results: The 1073 participants were 53% female, mean age 58 years (SD = 11), 67% non-Hispanic white, 12% non-Hispanic Black/African American, 12% Hispanic, 9% other or multiple races, 32% retired and 42% had less than a college degree. Regardless of income or race/ethnicity, nearly all participants (96-98%) viewed a NCSD result as somewhat or very valuable and anticipated maintaining or improving health behaviors (98-100%) and the majority expected positive emotional impacts (66-74%). However, minority groups were more likely than white participants to anticipate making lifestyle changes after a NCSD result (44-58% vs. 28%), increasing behaviors such as: exercising (61-75% vs. 47%), seeking health-related educational material (39-52% vs. 26%), eating healthy (58-78% vs. 47%), receiving vaccines (44-49% vs. 35%), maintaining/increasing adherence to recommended cancer screenings (22-29% vs 33% / 68-74% vs. 66%), and attending doctor visits (43-65% vs. 40%). Minorities also reported being more certain they would increase these behaviors than white participants. Lower to middle household income ( < $120,000) was associated with more positive impacts to self-care and monitoring health, relief, and happiness, and less fear, concern, anxiety, and stress after a NCSD result versus those with an income ≥$120,000. Conclusions: Regardless of income level or race/ethnicity, a negative MCED test result provides additional value to the US general population beyond traditional clinical benefits, has positive impacts on psychological/emotional health, and could promote adherence to or increase preventive healthcare behaviors. Importantly, racial/ethnic minorities and those of low to mid income anticipated greater positive impacts, specifically to preventive health behaviors with a negative MCED result.

Prevalence and risk factors for diabetic retinopathy at diagnosis of type 2 diabetes: an observational study of 77 681 patients from the Swedish National Diabetes Registry

IntroductionTo assess the prevalence of diabetic retinopathy (DR) in persons with newly diagnosed type 2 diabetes (T2D) to understand the potential need for intensified screening for early detection of T2D.Research...

Effect of multi-cancer early detection screening on late-stage cancers: A modeling study.

11076 Background: Emerging blood-based multi-cancer early detection (MCED) tests can revolutionize early cancer detection. We evaluated the potential impact of MCED screening in reducing risk of late-stage diagnosis of 12 specific cancers which represent 70% of all cancer incidence in the US. Methods: We developed Simulation Model for MCED (SiMCED), a microsimulation model of 12 solid tumor cancer types: breast, colorectal, endometrial, esophageal, gastric, kidney, liver, lung, ovarian, pancreatic, prostate, and urinary bladder. Transitions between cancer stages (I-IV) were driven by cancer type- and stage-specific dwell times, which were synthesized from published literature and empirical estimates. MCED test sensitivity was derived from the PRE-ASCEND study on average-risk American adults. The model was calibrated to reproduce yearly observed cancer incidence diagnosed symptomatically or through screening as captured in the Surveillance, Epidemiology, and End Results (SEER) database, while accounting for unobserved cancer incidence by age, sex, and cancer type and stage. Using a 50-year time horizon, we simulated 100,000 individuals aged 50 to 84 years. Diagnosis of cancer could arise from usual care (UC) or annual MCED screening. Results: Over the 50-year horizon, MCED screening of 100,000 individuals resulted in 1,323 fewer Stage IV (24%) diagnoses relative to UC, with 38% of Stage IV reductions attributed to non-screening-detectable cancer types (i.e., those without recommended screening guidelines). The table displays absolute and percentage reductions in Stage IV diagnoses for the 8 cancer types with the highest absolute reduction in Stage IV diagnoses. The percentage of Stage IV reduction was 21% for screening-detectable cancers and 29% for non-screening-detectable cancers. Conclusions: Our study suggests that MCED screening could be effective for reducing the incidence of Stage IV cancer, which is associated with the worst survival and quality of life. Of note, MCED has the potential to reduce Stage IV cancer incidence for cancers without recommended screening guidelines. However, the real-world impact of MCED tests and their cost-effectiveness require further investigation. [Table: see text]

Simple and Fast Prediction of Gestational Diabetes Mellitus Based on Machine Learning and Near-Infrared Spectra of Serum: A Proof of Concept Study at Different Stages of Pregnancy.

Gestational diabetes mellitus (GDM) is a hyperglycemic state that is typically diagnosed by an oral glucose tolerance test (OGTT), which is unpleasant, time-consuming, has low reproducibility, and results are tardy. The machine learning (ML) predictive models that have been proposed to improve GDM diagnosis are usually based on instrumental methods that take hours to produce a result. Near-infrared (NIR) spectroscopy is a simple, fast, and low-cost analytical technique that has never been assessed for the prediction of GDM. This study aims to develop ML predictive models for GDM based on NIR spectroscopy, and to evaluate their potential as early detection or alternative screening tools according to their predictive power and duration of analysis. Serum samples from the first trimester (before GDM diagnosis) and the second trimester (at the time of GDM diagnosis) of pregnancy were analyzed by NIR spectroscopy. Four spectral ranges were considered, and 80 mathematical pretreatments were tested for each. NIR data-based models were built with single- and multi-block ML techniques. Every model was subjected to double cross-validation. The best models for first and second trimester achieved areas under the receiver operating characteristic curve of 0.5768 ± 0.0635 and 0.8836 ± 0.0259, respectively. This is the first study reporting NIR-spectroscopy-based methods for the prediction of GDM. The developed methods allow for prediction of GDM from 10 µL of serum in only 32 min. They are simple, fast, and have a great potential for application in clinical practice, especially as alternative screening tools to the OGTT for GDM diagnosis.

The Spanish Familial Pancreatic Cancer Registry (PANGENFAM): a decade follow-up of individuals at high-risk for pancreatic cancer

The Spanish Familial Pancreatic Cancer Registry (PANGENFAM) was established in 2009 and aims to characterize the genotype and phenotype of familial pancreatic cancer (FPC). Furthermore, an early detection screening program for pancreatic ductal adenocarcinoma (PDAC) is provided to healthy high-risk individuals from FPC and hereditary pancreatic cancer families (first-degree relatives). This article describes our experience over the last 10 years in high-risk screening. Hereditary and familial pancreatic cancer families were identified through the oncology and gastroenterology units. High-risk individuals underwent annual screening with endoscopic ultrasound (EUS) and magnetic resonance (MRI) from age 40 or 10 years younger than the youngest affected family member. Results: PANGENFAM has enrolled 290 individuals from 143 families, including 52 PDAC cases and 238 high-risk individuals. All high-risk individuals eligible for screening were offered to enter the surveillance program, with 143 currently participating. Pancreatic abnormalities were detected in 94 individuals (median age 53 years (29–83), with common findings including cystic lesions and inhomogeneous parenchyma. Imaging test concordance was 66%. Surgical intervention was performed in 4 high-risk individuals following highly suspicious lesions detected by imaging. PANGENFAM is a valuable resource for science innovation, such as biobanking, with clinical and imaging data available for analysis. For high-risk families, it may offer a potential for early diagnosis. Collaboration with other national and international registries is needed to increase our understanding of the disease biology and to standardize criteria for inclusion and follow-up, optimizing cost-effectiveness and efficacy.

Abstract PO2-10-10: Developing a Continuum of Care Model to Address Healthcare Disparities in Breast and Cervical Cancer: The Promise Fund's Approach

Abstract The Promise Fund is creating a systemic change in healthcare service delivery through its Continuum of Care model in which patients are provided health education, navigation for breast and cervical health, affordable early detection screenings, diagnostics, treatment, and/or support services through an established network of providers, reducing healthcare costs, alleviating the burden of our complex healthcare system, and improving patient outcomes. This model, established in Palm Beach County, has potential to be scaled across Florida and beyond. The Promise Fund's primary focus is to eliminate preventable deaths and stop the progression of breast and cervical cancer among women in South Florida. The region faces significant healthcare disparities, with over 80,000 uninsured women in Palm Beach County alone. Disproportionately affecting minority groups, these women often experience delayed diagnoses and higher mortality rates compared to White women. Barriers such as transportation, translation, education, and childcare further contribute to suboptimal survival rates, despite high cure rates exceeding 95% for breast and cervical cancer. Through public and private partnerships, the Promise Fund established a Women's Health Center co-located at a Palm Beach County Federally Qualified Health Center (FQHC). FHQCs are community-based facilities that provide comprehensive primary care services to uninsured or low-income individuals in areas of high need. At this strategically selected FQHC, the Promise Fund supplies state-of-the-art equipment for breast and cervical cancer screenings, such as a 3D Genius Mammography Machine, donated by Hologic, Inc., ultrasounds, LEEP, and colposcopy. To facilitate access, the Promise Fund employs over 20 patient navigators positioned in FQHCs, free clinics, and community-based organizations across South Florida. These navigators connect women to resources, engage in outreach, and enroll at-risk individuals into the program. The impact of the navigators is significant, with over 20,000 women engaged, over 80 cancers treated, more than 5,000 women finding medical homes, and over 19,000 women receiving education and outreach. Additionally, the program has facilitated over 4,000 mammograms and 2,000 pap tests, all provided at little to no cost to the patients. Promise Fund Patient Navigators are well-trained, culturally competent, and bilingual. They help patients overcome barriers to care, arranging transportation, childcare, and translation services. Our navigators are carefully selected from the community and undergo rigorous training in breast and cervical health, navigation, and reporting. Moreover, the Promise Fund supports patients throughout their cancer journey by brokering low-cost or free treatment from private hospitals. Despite the prevailing healthcare disparities, the Promise Fund's patient-centered approach has yielded positive outcomes. Over 98% of women navigated by the organization comply with receiving their screening mammogram, drastically surpassing the national average. Research has consistently demonstrated that patient navigators significantly improve patient outcomes by facilitating early screening and timely access to treatment, thus reducing disease progression and healthcare costs. Additionally, the Promise Fund’s expansive Continuum of Care model effectively decreases the time patients have to wait between diagnosis and starting treatment, as well as decreases the overall treatment time for patients. The success of the Promise Fund's inaugural Women's Health Center has led to the replication of this model in three additional FQHCs in Palm Beach and Broward County, ensuring that no woman in these areas should go without essential breast and cervical cancer resources. Citation Format: Nancy Brinker, Donna Shalala, Edith Mitchell, Haywood Brown, Wayne Frederick, Jane Mendez, Deeptee Jain, David Dodson, David Brodsky, Lillie Shockney. Developing a Continuum of Care Model to Address Healthcare Disparities in Breast and Cervical Cancer: The Promise Fund's Approach [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-10.

Pharmacists perceptions of providing colorectal cancer screening in community-based practice

BackgroundColorectal cancer (CRC) is the third most common diagnosed cancer in the United States. Kentucky pharmacists can be instrumental in the CRC early detection process through board-authorized protocols (BAPs): a regulatory approach managed by the Kentucky Board of Pharmacy that allows pharmacists to increase access to care while saving lives through early detection screening. Determining the barriers and successes of implementing CRC screening can improve access to education and care for patients. ObjectiveThis study aimed to evaluate community pharmacists’ perceptions of implementing a colorectal screening for patients via protocol and identify pharmacists’ confidence and potential barriers such as cost, staff support, and patient need for colorectal screening in community pharmacy settings. MethodsA survey was sent electronically to a convenience sample of pharmacists throughout Kentucky. The survey collected demographics, opinions regarding implementation of the CRC screening protocol, pharmacists’ perceptions of knowledge, and the barriers and benefits associated with implementation of CRC services. ResultsA total of 207 responses were received and of those 151 were from community-based pharmacists; 34% of pharmacists agreed or strongly agreed to offer CRC screening. Overwhelmingly, 81.3% of pharmacists reported need for additional training. There were no statistically significant differences in support among demographic factors: practice setting (P = 0.937), gender (P = 0.973), age (P = 0.568), and years practicing (P = 0.870). In addition, the most common barriers reported were lack of reimbursement (97%), lack of willingness for patients to pay (98%), and time or workflow issues (97%). Most pharmacists stated that lack of trust in pharmacists was not a barrier (87%). ConclusionsOverall, 34% of pharmacists either agreed or strongly agreed to offer CRC screening via the board-approved protocol. However, overwhelmingly the pharmacists believe that there is a need for additional training and opportunities for additional training on BAPs have increased drastically in Kentucky. Barriers such as lack of reimbursement, willingness to pay, and time or workflow issues need to be overcome before implementation. Finding solutions to these barriers will increase pharmacist’s support.

Screening for Nephropathy in Pediatric Type 2 Diabetes: Quality Improvement to Increase Nephropathy Screening.

Screening for early detection of microalbuminuria signaling kidney disease should begin as early as the time of diagnosis of youth-onset type 2 diabetes. This quality improvement initiative aimed to standardize urine nephropathy screening in pediatric patients with type 2 diabetes at a tertiary academic medical center and increase a baseline screening rate of 56%-75% over 6 months (September 2022-February 2023) and sustain that increase for 6 months (March through August 2023). A multi-disciplinary team used quality improvement methods and iterative Plan-Do-Study-Act cycles. Targeted interventions included previsit planning workflow, education, and a new-onset triage protocol. The team collected data at baseline and prospectively by reviewing electronic medical records. The primary outcome measure was pediatric type 2 diabetes clinic visits in diabetes clinic with urine nephropathy screening before or on the visit date. A total of 121 youth were scheduled for T2D clinic visits between September 2021 and August 2023. The mean age was 14.5 years, and 60% were women, 40% were non-Hispanic Black, 28% were Hispanic/Latino, and 15% reported Spanish as their preferred language. Following the interventions of this project, urine nephropathy screening increased from 56% to 75%, and this change was sustained for 6 months. Interventions focused on efficient recognition of the population needing screening, coordinated internal processes around screening, a shared understanding between all stakeholders, and practical support in the healthcare system increased urine nephropathy screening with sustained improvement.