Investigation of the Effectiveness of Anal Cancer Screening in HIV Patients
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BACKGROUND: The main risk factor for the development of anal cancer is acquisition of human papilloma virus (HPV), which occurs at a higher probability in human immunodeficiency virus (HIV)-infected individuals. Our hypothesis is that annual screening amongst the highly vulnerable HIV population will result in earlier detection of anal cancer and improved patient outcomes. OBJECTIVE: The main objective of this project is to improve patient outcomes by increasing the number of monthly anal pap smears performed at Amelia Court by 20%, by January 2017. METHODS: The project was conducted at Amelia Court, an HIV clinic attached to a larger safety net hospital in an urban setting. Our baseline data was determined by studying the absolute number of anal Paps performed in a 28 day period. The project utilized a variety of quality improvement tools to analyze the effects of a two-step educational process. Implementation 1: provider re-education program focusing on the importance of anal cancer screening in HIV patients. Implementation 2: creation of an infographic to be displayed in patient rooms, encouraging patients to request anal cancer screening from their providers. RESULTS: Implementation 1: demonstrated a 21.33% increase in the number of anal Paps collected. Implementation 2: anticipated results will be available by November, representing a 28 day cycle. CONCLUSION: The provider re-education program showed an increase in the absolute number of anal Paps performed at Amelia Court. The limited time frame since implementation precludes further analyses at this point. However, initial results suggest that these processes will improve anal cancer outcomes in vulnerable populations.