Colorectal cancer screening among a sample of community health center attendees.

To determine the rate of colorectal cancer screening in patients attending a sample of community health centers, medical records of 1,176 patients from eight community health centers were abstracted. Among the patients studied, 43.8% of patients had undergone at least one of the three colorectal screening tests (fecal occult blood test, colonoscopy, or flexible sigmoidoscopy) in the recommended interval. Colorectal screening in this community health center population was predicted by male gender, being African American, older age, having a greater number of chronic illnesses, a family history of colorectal cancer, and by having engaged in other preventive cancer screenings in the previous year. Although screening rates certainly were not optimal, they compare favorably to rates reported in national surveys for the general population. Our results add to a growing body of evidence that community health centers, despite serving disadvantaged populations, are able to deliver preventive care at rates comparable to health facilities used by the general population.

Empiric treatment of minimally abnormal papanicolaou smears with 0.75% metronidazole vaginal gel.

BACKGROUND: The purpose of this study was to compare the efficacy of 0.75% metronidazole vaginal gel with no treatment in patients who have had a minimally abnormal Papanicolaou smear. METHODS: One hundred forty-five patients whose initial Papanicolaou smears were limited by inflammation or benign cellular changes, reactive cellular changes, or atypical squamous cells of undetermined significance that did not favor a neoplastic process were randomized to 5 days of treatment with 0.75% metronidazole vaginal gel or to a control group receiving no treatment. Papanicolaou smears were repeated after 3 to 4 months. RESULTS: Cytologic findings of the follow-up Papanicolaou smears were normal in 61 of 114 (54%) of patients. Sixty-two percent (n = 37) of the Papanicolaou smears in the control group converted to normal on follow-up, whereas 44% (n = 24) of the Papanicolaou smears in the treatment group converted to normal (P = .07). Only one follow-up Papanicolaou smear worsened to low-grade squamous intraepithelial lesion. In no subgroup was treatment effective. CONCLUSIONS: Empiric treatment for an asymptomatic, minimally abnormal Papanicolaou smear with 0.75% metronidazole vaginal gel before a repeated cytologic examination did not improve the rate of reversion to normal cytologic findings.