Breast cancer and gynecologic risks in lesbian and bisexual women.

ABSTRACT: Lesbian and bisexual women may be at an increased risk for gynecologic infections and breast cancer due to a higher prevalence of factors such as obesity, smoking, and lower pregnancy rates. This article discusses the role of healthcare professionals in preventive screening for breast and gynecologic cancers and promoting healthy living in these patients by avoiding smoking, maintaining an ideal body weight, and limiting alcohol consumption.

Midwives' practices related to cervical cancer screening during pregnancy: A vignette-based study.

OBJECTIVE: To describe midwives' practices related to cervical cancer screening and women's eligibility for screening during pregnancy. STUDY DESIGN: Cross-sectional vignette-based study of French midwives during February-May 2018. MAIN OUTCOME MEASURES: Participants were asked to complete an internet-based questionnaire: a clinical case-vignette about a woman eligible for cervical cancer screening during pregnancy and a short self-administered questionnaire. RESULTS: We obtained 273 complete questionnaires from eligible midwives. Of those responding, 15% reported that they never screened for cervical cancer during pregnancy, 63.7% did so for women 25 years or older, and 51% adhered to the recommended intervals between tests. Overall, 110 (40%) midwives adhered to the complete screening protocol (age at initiation and interval). In this clinical case vignette of a woman meeting the criteria for screening, only 29% of midwives reported they would perform a Pap test at 25 weeks of gestation, while 91% would at 10 weeks. CONCLUSION: Midwives' practices of cervical cancer screening and their determination of women's eligibility during pregnancy vary, especially according to gestational age; Nevertheless, pregnancy is an appropriate time to screen women who meet the criteria for cervical cancer screening, especially if they are not receiving regular gynaecological care.

Understanding primary care nurses' contribution to cancer early diagnosis: A systematic review.

PURPOSE: Primary care nurses can contribute to cancer early diagnosis. The objective of this systematic review was to identify, appraise and synthesise evidence on primary care nurses' contribution towards cancer early diagnosis in developed countries. METHOD: The following databases were searched in September 2017: MEDLINE, PsychINFO, CINAHL, SCOPUS, and EMBASE. Data were extracted on nurses': knowledge of cancer; frequency of 'cancer early diagnosis-related discussions' with patients; and perceived factors influencing these discussions. Studies were appraised using the Mixed Methods Appraisal Tool. RESULTS: Twenty-one studies were included from: United States, United Kingdom, Ireland, Spain, Turkey, Australia, Brazil and Middle East. Studies were mostly of low quality (one did not meet any appraisal criteria, 15 met one, four met two, and one met three). Nurses' knowledge of cancer, and their frequency of 'cancer early diagnosis-related discussions', varied across countries. This may be due to measurement bias or nurses' divergent roles across healthcare systems. Commonly perceived barriers to having screening discussions included: lack of time, insufficient knowledge and communication skills, and believing that patients react negatively to this topic being raised. CONCLUSIONS: Findings suggest a need for nurses to be adequately informed about, and have the confidence and skills to discuss, the topic of cancer early diagnosis. Further high-quality research is required to understand international variation in primary care nurses' contribution to this field, and to develop and evaluate optimal methods for preparing them for, and supporting them in, this.

Prostate Cancer: How Nurse Practitioners Can Aid in Disease Diagnosis and Management.

Early diagnosis and management of prostate cancer is crucial to providing safe, high-quality care to patients. Understanding the complexities of the signs and symptoms of prostate cancer can help nurse practitioners (NPs) make timely decisions to assess a patient's complaints and consider differential diagnoses. Acting on diagnostics, NPs can guide patients through treatment strategies to ensure positive health outcomes.

Breast Cancer Risk Prediction Models: Challenges in Clinical Application.

Various breast cancer risk prediction models (BCRPMs) exist to assess an individual's risk of developing malignancy and risk of having a mutation associated with hereditary risk of developing cancer. This article provides oncology nurses with current information on the available BCRPMs and highlights nursing implications. Oncology nurses' understanding of BCRPMs can help to ensure that patients are receiving accurate and useful information related to their risks.

Cáncer de próstata: conocimientos e interferencias en la promoción y prevención de la enfermedad / Câncer de próstata: conhecimentos e interferências na promoção e prevenção da doença / Prostate cancer: knowledge and interference in the promotion and prevention of the disease

El artículo objetivó describir la percepción de los hombres sobre el cáncer de próstata y los factores de prevención relacionados. Se trata de un estudio cualitativo del tipo de ensayo comunitario. Se realizaron tres reuniones en forma de grupo focal, compuesto por 60 hombres con rango de edad superior a 40 años, abordando el tema del cáncer de próstata. Para el análisis de los datos cualitativos se realizó el análisis de contenido temático y los datos fueron organizados en el software - Atlas Ti. Los resultados fueron referenciados en los objetivos de este estudio y enfatizados en categorías. Los datos evidenciaron que todavía hay una barrera física y social a ser superada ante los estigmas masculinos, y existe una carencia de conocimiento sobre la prevención de este cáncer. El aumento de la oferta de exámenes diagnósticos, agilidad en la atención, horarios diferenciados para los trabajadores son algunas de las estrategias eficientes para atraer a esta población para la prevención del cáncer de próstata

O artigo objetivou descrever a percepção dos homens sobre o câncer de próstata e os fatores de prevenção relacionados. Trata-se de um estudo qualitativo do tipo ensaio comunitário. Foram realizadas três reuniões em forma de grupo focal, composto por 60 homens com faixa etária superior a 40 anos, abordando o tema do câncer de próstata. Para a análise dos dados qualitativos foi realizada a análise de conteúdo temática e os dados foram organizados no software - Atlas Ti. Os resultados foram referenciados nos objetivos deste estudo e enfatizados em categorias. Os dados evidenciaram que ainda há uma barreira física e social a ser ultrapassada diante dos estigmas masculinos, e existe uma carência de conhecimento sobre a prevenção deste câncer. O aumento da oferta de exames diagnósticos, agilidade no atendimento, horários diferenciados para os trabalhadores são algumas das estratégias eficientes para atrair esta população para a prevenção do câncer de próstata

The article aimed to describe the men's perception about prostate cancer and related prevention factors. This is a qualitative community trial type study. Three meetings were held in the form of a focus group, composed of 60 men aged over 40 years old, addressing the topic of prostate cancer. In order to analyze the qualitative data, thematic content analysis was performed and the data were organized in the software - Atlas Ti. The results were referenced in the objectives of this study and emphasized into categories. The data showed that there is still a physical and social barrier to overcome with male stigmas, and there is a lack of knowledge about the prevention of this cancer. The increase in the availability of diagnostic tests, agility in care, and differentiated schedules for workers are some of the efficient strategies to attract this population to the prevention of prostate cancer

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

OBJECTIVE: To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. DESIGN: Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. SETTING: Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). MAIN OUTCOME MEASURES: Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). RESULTS: For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. CONCLUSION: The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Detecção precoce e abordagem do câncer infantil na atenção primária / Early detection and child cancer approach for primary care

Objetivo: identificar as produções científicas que abordam a participação do enfermeiro, que atua na Atenção Primária, na detecção precoce e no manejo dos casos de câncer na infância. Método: estudo bibliográfico, descritivo, tipo revisão integrativa, com busca na Biblioteca Virtual em Saúde, no recorte temporal em abril de 2017. Os dados foram analisados com a modalidade Temática da proposta da Análise de Conteúdo. Resultados: são fatores limitantes à abordagem do câncer a falha na comunicação entre os profissionais generalistas e especialistas; a fragmentação do cuidado; a falta de preparo e treinamento de profissionais generalistas e a ausência de procura por diretrizes, resumos de tratamento e planos de cuidados por parte dos profissionais. Conclusão: o enfermeiro tem participação importante nos diagnósticos das oncologias pediátricas, por meio da detecção de alterações fisiológicas, estabelecendo relação de ajuda com paciente e família, por meio da comunicação efetiva, medidas para alívio do sofrimento e apoio aos familiares. Tais práticas, porém, não têm sido foco de estudos científicos tornando-se necessário maior produção de conhecimento na área que permitirá uma prática mais embasada, concreta e segura.(AU)

A nurse-led cervical screening clinic in primary care.

Eliza is a practice nurse in a large general practice in England. She is trained in cancer screening and health promotion as well as chronic disease management. Today patients are consulting with her for their cervical smear test.

The economic impact of a nurse practitioner-directed lung cancer screening, incidental pulmonary nodule, and tobacco-cessation clinic.

OBJECTIVE: Lung cancer screening programs have become increasingly prevalent within the United States after the National Lung Screening Trial results. We aimed to review the financial impact after programmatic implementation of Advanced Registered Nurse Practitioner-led programs of Lung Cancer Screening and Tobacco Related Diseases, Incidental Pulmonary Nodule Clinic, and Tobacco Cessation Services. METHODS: We reviewed revenue from 2013 to 2016 by our nurse practitioner-led program. Encounters were queried for charges related to outpatient evaluation and management, professional procedures, and facility charges related to both outpatient and inpatient procedures. Revenue was normalized using 2016 data tables and the national Medicare conversion factor (35.8043). RESULTS: Our program evaluated 694 individuals, of whom 75% (518/694) are enrolled within the lung cancer-screening program. Overall revenue associated with the programs was $733,336. Outpatient evaluation and management generated revenue of $168,372. In addition, professional procedure revenue accounted for an additional $60,015 with facility revenue adding an additional $504,949. CONCLUSIONS: A nurse practitioner-led program of lung cancer screening, incidental pulmonary nodules, and tobacco-cessation services can provide additional revenue opportunities for a Thoracic Surgery and Interventional Pulmonology Division, as well as a health care system. The current national, median annual wage of a nurse practitioner is $98,190, and the cost associated directly to their salary (and benefits) may remain neutral or negative within certain programs. However, the larger economic benefit may be realized within the division and institution. This potential additional revenue appears related to evaluation of newly identified diseases and subsequent evaluations, procedures, and operations.

Population-based Cancer Screening: Measurement of Coordination and Continuity of Care.

BACKGROUND: European guidelines for the quality of screening programs for breast and colorectal cancer describe process, structure, and outcome indicators. However, none of them specifically evaluate coordination and continuity of care during the cancer screening process. OBJECTIVES: The aim of this study was to identify and adapt care quality indicators related to the coordination and continuity of the cancer screening process to assess nursing care in cancer screening programs. METHODS: The indicators proposed in this study were selected in 2 phases. The first consisted of a literature review, and the second was made by consensus of an expert group. An electronic literature search was conducted, through June 2016. From a total of 225 articles retrieved, 14 studies met inclusion criteria, and these 14 documents were delivered to the group of experts for evaluation and to propose a final list of agreed-upon indicators. RESULTS: The group of experts selected 7 indicators: adequacy and waiting time derivation of participants, delivery and availability of the report of the process, understanding professionals involved in the process, and satisfaction and understanding of participants. CONCLUSIONS: These indicators should help identify areas for improvement and measure the outcome of coordination and continuity of care. IMPLICATIONS FOR PRACTICE: The results provided a common set of indicators to evaluate the coordination and continuity of care for cancer screening and to consequently assess the contribution of nursing care in cancer screening programs. The identification and adaptation of these quality indicators will help to identify areas for improvement and measure the effect of coordination and continuity of care.

Colorectal cancer screening: Using evidence-based guidelines.

Colorectal cancer is the third most common cancer diagnosed in men and women. There are multiple options for prevention and early detection. Evidence-based guidelines are available to select the best option based on personal and family history. NPs should utilize these guidelines in clinical practice to select the appropriate screening for their patients.

Early Detection and Screening for Breast Cancer.

OBJECTIVE: To review the history, current status, and future trends related to breast cancer screening. DATA SOURCES: Peer-reviewed articles, web sites, and textbooks. CONCLUSION: Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early stage disease and decrease mortality. Although politics and economics may inhibit organized mammography screening programs in many countries, the judicious use of proficient clinical and self-breast examination can also identify small tumors leading to reduced morbidity. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have exciting opportunities to lead, facilitate, and advocate for delivery of high-quality screening services targeting individuals and communities. A practical approach is needed to translate the complexities and controversies surrounding breast cancer screening into improved care outcomes.

Screening and Early Detection of Lung Cancer.

OBJECTIVE: To review current risk factors for lung cancer, identify screening and early detection guidelines while describing new approaches that use genomic technologies. DATA SOURCES: Published scientific literature, clinical literature, and published lung cancer screening guidelines from the United States and Canada. CONCLUSION: Nurses are caring for lung cancer patients who, historically, do not live for long periods after diagnosis. Research is revealing promising screening methodologies that can detect lung cancer 1 to 4 years earlier than the current approaches. IMPLICATIONS FOR NURSING PRACTICE: Current knowledge about screening for lung cancer is a vital tool for nurses working with persons at high risk for this potentially aggressive and life-threatening malignancy. While old methods remain the standard of care, new detection methods use a variety of genomic-based technologies. These developing approaches emphasize the need for nurses at all levels of practice to have a working knowledge of genetics to educate patients and conference with colleagues.

Disparities in Cancer Screening Practices among Minority and Underrepresented Populations.

OBJECTIVES: To review current evidence about cancer screening challenges that lead to cancer health disparities in minority populations. DATA SOURCES: Research reports, published journal articles, web sites, and clinical practice observations. CONCLUSION: There are significant disparities that exist in cancer screening practices among racial and ethnic minority and underrepresented populations, resulting in disproportionately higher cancer mortality rates in these populations. IMPLICATIONS FOR NURSING PRACTICE: Nurses are positioned to lead in educating, promoting, and bringing awareness to cancer screening recommendationsand current cancer prevention guidelines for at-risk individuals, and help them to implement these guidelines to reduce incidence and mortality.

Cancer Screening and Early Detection in the 21st Century.

OBJECTIVE: To review the trends in and principles of cancer screening and early detection. DATA SOURCES: Journal articles, United States Preventive Services Task Force (USPSTF) publications, professional organization position statements, and evidence-based summaries. CONCLUSION: Cancer screening has contributed to decreasing the morbidity and mortality of cancer. Efforts to improve the selection of candidates for cancer screening, to understand the biological basis of carcinogenesis, and the development of new technologies for cancer screening will allow for improvements in cancer screening over time. IMPLICATIONS FOR NURSING PRACTICE: Nurses are well-positioned to lead the implementation of cancer screening recommendations in the 21st century through their practice, research, educational efforts, and advocacy.

Cervical Cancer: Prevention and Early Detection.

OBJECTIVE: To review effective methods of prevention that can be used to control the incidence of cervical cancer and detection strategies that can identify the precancerous lesions before they become true cancer. DATA SOURCES: Current medical, scientific and nursing literature, and national and international guidelines of cervical cancer. CONCLUSION: Nearly all cervical cancers are caused by specific types of human papillomavirus (HPV). Prophylactic vaccination for HPV provides the most effective method of primary prevention against HPV-related diseases. The use of the Pap test and HPV test, according to published guidelines, provides the most effective means of screening for cervical cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses are in a key position to provide health education with the goal of supporting vaccine uptake and screening guidelines.

Gastrointestinal Cancers: Screening and Early Detection.

OBJECTIVE: To present an overview of current practices in the screening and early detection of gastrointestinal cancers. DATA SOURCES: Literature reviews. CONCLUSION: Screening for gastrointestinal cancers is less than desirable, particularly in underserved populations. There are inadequate methods of screening for early detection of esophageal and gastric cancers. IMPLICATIONS FOR NURSING PRACTICE: Education of patients is needed to reinforce the importance of screening for gastrointestinal cancers.

Prostate Cancer Screening.

OBJECTIVE: To review the current state of prostate cancer screening and future directions. DATA SOURCES: Nursing, medical and scientific literature related to prostate cancer screening, and national and international professional recommendations. CONCLUSION: Prostate cancer screening has been a topic of robust discussion for a number of years. Research continues to examine novel options for prostate cancer screening to either replace or compliment the prostate specific antigen test, but require additional validation before they will be widely accepted into clinical practice. IMPLICATIONS FOR NURSING PRACTICE: As new data emerges and professional organizations update their recommendations, it is important for oncology nurses to keep abreast of the latest developments to educate patients.