Many Americans would be shocked to learn that thousands of the country’s women die annually from an entirely preventable disease. But, every year, 4,000 women die in the US from cervical cancer. Deaths that could be prevented by routine screening tests. With well-woman exams now covered by the Affordable Care Act, it seems that American women have no reason to go without this essential medical service. However, other barriers, such as geography, prevent some women from receiving the healthcare they need.
Mobile health clinics and advanced telehealth services can help to reduce the number of women dying each year from this preventable illness.
Distance increases loss to follow-up
It seems like simple math; the further a patient has to travel to get to the doctor, the less likely they will do so. In the case of cervical cancer prevention, this can have a dramatic effect. The National Breast and Cervical Cancer Early Detection Program says, “Pap tests are underused by women who have no regular source of health care.” Although an essential part of healthcare, preventative medicine is frequently seen as a luxury that does not necessitate a longer journey.
Cancer screening loss to follow-up rates highlights the profound effect that distance has on people’s healthcare experience. Frequently, women fail to return for secondary screening or necessary treatment. The loss to follow-up rates for secondary screening has risen to 40% for women who have to travel 29 miles or more(1). This leaves many women who have abnormal test results at risk of developing cervical cancer, despite having received initial screening.
(1) Baker, K et.al “Factors Contributing to Non-Adherence of Follow-up in Patients Attending Colposcopy and Leep Clinic,” (poster, ASCCP 2018).
Mobile health clinics bring physicians to patients
Many healthcare providers have started traveling when patients won’t. Mobile Health Clinics (MHC) deliver health services in underserved and geographically remote communities using staffed medical vehicles. Currently, 2,000 MHCs bring care to up to 6.5 millions Americans with most of these clinics primarily focused on preventive and primary care.
Cervical cancer screening is one of many services offered by mobile health clinics. By detecting this disease while still in the precancerous stage saves lives and reduces the burden on the healthcare system. On average, every $1 spent on funding MHCs saves $12 on further treatment. The Boston based mobile health clinic, the Family Van, estimates a savings of $3,125,668 per year to the healthcare system. As with all MHCs, patients who use the Family Van services receive treatment before their condition requires them to turn to the Emergency Room or other hospital services.
Mobile health services can expand to include even more underserved populations by increasing telehealth options that take advantage of digital technology to connect physicians. The Health Wagon, which serves Appalachia, can offer additional services from five vehicles with telehealth support provided by the University of Virginia Health System.
Telehealth expands expert coverage
Telehealth options allow an expert physician to remotely oversee procedures taking place in the mobile health clinic. In the cervical cancer screening arena, the EVA System mobile colposcope opens the doors to advanced screening and treatment in remote areas. The EVA System uses smart technology to make colposcopy both portable and affordable. This digital colposcope allows for real-time consultation between users and expert consultants, as well as easy case sharing.
A portable telehealth solution for cervical cancer screening enables the expansion of secondary screening. This will cut the loss to follow-up rates, bringing more women to the preventative treatment needed to defeat cervical cancer.
Mobile health clinics go a long way in addressing the many challenges in reducing the number of preventable deaths to cervical cancer. In our combined fight against preventable deaths, concerned citizens can advocate for the expansion of MHC coverage and the adoption of the latest technologies to give physicians the tools they need to bring quality cervical cancer screening to all Americans.
