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The following is a summary of “Low-cost interventions to increase uptake of cervical cancer screening among emergency department patients: Results of a randomized clinical trial,” published in the January 2025 issue of Emergency Medicine by Adler et al.
Cervical cancer (CC) was understood to be preventable, with screening known to decrease mortality, yet patients of emergency department (ED) were disproportionately at high risk for nonadherence, making the ED a promising setting for interventions promoting such screening.
Researchers conducted a retrospective study to compare the effectiveness of basic referral and a text messaging intervention, based on behavioral change theory, in promoting CC screening uptake among patients from ED.
They randomized participants aged 21–65, identified as needing CC screening, into different study arms and followed them for 150 days. The primary outcome, interval CC screening uptake, was assessed, and methods-related moderators of intervention effects were analyzed. Participants were recruited from both a large, urban ED and a smaller, rural ED within the same health care system. Intervention arms were compared with historical controls.
The results showed 4,035 patients were surveyed, with 1,089 identified as needing CC screening and randomized. After 150 days, 20% in the basic referral arm and 23% in the basic referral plus text messaging arm obtained screening, compared to 10% in the historical control group. The difference between the intervention arms was not significant (P = 0.219). However, women aged ≥40 years had higher screening uptake with the text messaging intervention (P = 0.032). Both interventions, separately and combined, showed a significant increase in screening uptake compared to controls (P ≤ 0.001).
Investigators concluded that both evaluated low-intensity ED-based interventions significantly increased subsequent CC screening uptake compared to historical controls, with the higher-intensity intervention further increasing uptake among women aged 40 and older.