ASPO Abstracts
Domestic abuse screening among breast and cervical cancer oncology clinics at safety-net hospital
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2019
Abstract Body:
Purpose of Study: Domestic abuse can directly and indirectly impact breast and cervical cancer incidence and survivorship. New evidence suggests domestic abuse screening in oncology clinics, coupled with appropriate referrals, can improve patient outcomes. The purpose of this study is to evaluate the extent of domestic abuse screening in oncology clinics at an integrated, safety-net health system. Methods: We extracted electronical health record (EHR) data on a population of patients diagnosed with breast or cervical cancer and receiving care in an integrated safety-net healthcare system from 2010-2017. All encounters were dichotomized as either an oncology encounter or other encounter (e.g. Emergency Department, inpatient, primary care). Domestic abuse is systematically screened using a single-item measure administered verbally by a nurse or medical assistant. Among the same cohort of cancer survivors, we conducted phone surveys and administered a 9-item, validated domestic abuse screener.Results: Among 2,524 breast or cervical cancer survivors, domestic abuse screening was documented in 37.3% of oncology encounters and, of those encounters, 0.4% of cancer survivors screened positive for domestic abuse. No cancer survivors screened positive more than once in oncology. Among all other health system encounters (i.e. excluding oncology), domestic abuse was identified in 1.6% of cancer survivors. Among phone surveys, 48% of cancer survivors screened positive for domestic abuse and, of those, 56% were interested in connecting to professional help within the health system. Conclusions: The EHR can be a useful tool for documenting domestic abuse, especially in oncology clinics. However, current efforts fail to identify a substantial number of patients. Clinical education of oncology teams could improve motivation to screen, understanding of domestic violence, and its impact on cancer treatment and survivorship.
Keywords: electronical health record; domestic abuse; cancer survivorship; breast; cervical