1. Up-to-date on cancer screening among Ontario patients seen by walk-in clinic physicians: A retrospective cohort study.
- Author
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Lofters A, Salahub C, Austin PC, Bai L, Berthelot S, Bhatia RS, Desveaux L, Ivers NM, Kiran T, Maclure M, Martin D, McBrien KA, McCracken R, Paterson JM, Rahman B, Shuldiner J, Tadrous M, Thakkar N, and Lapointe-Shaw L
- Subjects
- Humans, Ontario, Early Detection of Cancer methods, Retrospective Studies, Cohort Studies, Mass Screening, Physicians, Neoplasms
- Abstract
Walk-in clinics are typically viewed as high-volume locations for managing acute issues but also may serve as a location for primary care, including cancer screening, for patients without a family physician. In this population-based cohort study, we compared breast, cervical and colorectal cancer screening up-to-date status for people living in the Canadian province of Ontario who were formally enrolled to a family physician versus those not enrolled but who had at least one encounter with a walk-in clinic physician in the previous year. Using provincial administrative databases, we created two mutually exclusive groups: i) those who were formally enrolled to a family physician, ii) those who were not enrolled but had at least one visit with a walk-in clinic physician from April 1, 2019 to March 31, 2020. We compared up to date status for three cancer screenings as of April 1, 2020 among screen-eligible people. We found that people who were not enrolled and had seen a walk-in clinic physician in the previous year consistently were less likely to be up to date on cancer screening than Ontarians who were formally enrolled with a family physician (46.1% vs. 67.4% for breast, 45.8% vs. 67.4% for cervical, 49.5% vs. 73.1% for colorectal). They were also more likely to be foreign-born and to live in structurally marginalized neighbourhoods. New methods are needed to enable screening for people who are reliant on walk-in clinics and to address the urgent need in Ontario for more primary care providers who deliver comprehensive, longitudinal care., Competing Interests: Declaration of Competing Interest This study received funding from CIHR (grant #175285). Aisha Lofters is the Chair in Implementation Science at the Peter Gilgan Centre for Women's Cancers in partnership with the Canadian Cancer Society. She is supported as a Clinician Scientist by the Department of Family and Community Medicine at the University of Toronto. Lauren Lapointe-Shaw is supported by the University of Toronto Department of Medicine, the Toronto General Hospital Research Institute, the Women's College Institute for Health System Solutions and Virtual Care (WIHV), and the Peter Gilgan Centre for Women's Cancers at Women's College Hospital, in partnership with the Canadian Cancer Society. Tara Kiran is the Fidani Chair of Improvement and Innovation at the University of Toronto. She is supported as a Clinician Scientist by the Department of Family and Community Medicine at St. Michael's Hospital and the University of Toronto. Noah M. Ivers is supported by a Canada Research Chair in Implementation of Evidence-based Practice and a Clinician Scholar award from the Department of Family and Community Medicine at Women's College Hospital and the University of Toronto. Simon Berthelot holds a Junior 2 Career Award from the Fonds de recherche du Québec - Santé (FRQS). Simon Berthelot receives research funding from Meridian Bioscience and Abbott to test their bedside COVID screening device in the emergency department setting., (Copyright © 2023. Published by Elsevier Inc.)
- Published
- 2023
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