ASPO Abstracts
Examining Predictors of Diagnosed Malignant Neoplasms of the Female Genital Tract in Emergency Department Settings
Category: Early Detection & Risk Prediction, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Purpose Very few studies have examined cancer diagnoses in emergency departments (EDs) using national data among women, although these facilities are sometimes used as an alternative to primary care. The purpose of this study was to examine predictors of diagnosed malignant neoplasms of the female genital tract in EDs among women who have visits related to reproductive healthcare. Methods This retrospective repeated cross-sectional study used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) between 2009 and 2013. This survey, which comprises a national probability sample of visits to emergency departments of 600 non-institutional hospitals, was conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. We included all women who were more than 15 years of age and had visits to EDs seeking reproductive healthcare services. Patient information was weighted to account for non-response and sampling bias. Bivariate analyses were conducted between demographic variables and frequency of diagnosis with malignant neoplasms using chi-square tests. Multinomial logistic regression was used to control for potential confounders to examine associations between reasons for visits to EDs and malignant neoplasm diagnoses using SAS® Statistical Software Version 9.4 (Cary, NC). Results A total of 2,620 women were included in the study. Five percent (n=140) were diagnosed with a malignant neoplasm during an ED visit of which the majority were malignant neoplasms of the uterus. Associations between increased age group (p<0.001) with diagnosis of malignant neoplasm as well as type of diagnostic services performed (p<0.001) with malignant neoplasms were observed. The likelihood of being diagnosed with malignant neoplasms was more than twenty times greater among women presenting to the ED with complaints of uterine fibroids (aOR: 21.5, 95% CI: 4.58, 101.1). Conclusions This study revealed that, among women who sought reproductive healthcare in EDs, those who presented with uterine fibroids were more likely to be diagnosed with a malignant neoplasm. Further studies are warranted to examine how safety net healthcare facilities may function as an alternative to women seeking reproductive healthcare in an ED.
Keywords: Emergency Departments (EDs), National Hospital Ambulatory Medical Care Survey (NHAMCS), Malignant Neoplasm, Women