Parkland-UT Southwestern PROSPR Center Colon Cancer Screening in a Safety net

描述（由申请人提供）：扩展后的帕克兰- ut西南prosper中心的总体目标是在我们的综合安全网系统中优化宫颈癌和结肠癌筛查。我们的研究对象是PROSPR网络中最多样化和最弱势的人群，代表了很少被纳入大规模研究网络的患者。帕克兰的宫颈癌筛查合格人群超过78,000名成年妇女，其中61%为西班牙裔，24%为非洲裔美国人，8%为非西班牙裔白人。他们都是低收入者，很少有私人保险，这导致他们依赖公共保险或慈善护理。因此，我们的患者代表了“传统上服务不足”的群体，经历着宫颈癌的差异——更高的发病率和死亡率，更低的筛查和HPV疫苗接种。帕克兰通过一个由11个社区初级保健诊所、11个妇女健康中心和专科诊所（发育不良、妇科和肿瘤学）组成的综合系统，提供完整的宫颈癌筛查过程（风险评估、早期检测、诊断评估和治疗）。所有诊所共享一个全面的电子医疗记录（EMR），通过该电子记录，检查资格、检查订单、结果、转诊和治疗都可通过电子方式确定。我们的中心将扩大，增加子宫颈筛查过程文件单位（SPDU）和子宫颈研究中心。宫颈SPDU将：1)利用帕克兰的电子病历来收集包括患者、提供者、诊所、系统和健康政策在内的多个层面的宫颈癌筛查过程的准确数据，2)安全地转移

DESCRIPTION (provided by applicant): The overall goal of the expanded Parkland-UT Southwestern PROSPR Center is to optimize cervical and colon cancer screening in our integrated safety-net system. The population we contribute is the most diverse and disadvantaged in the PROSPR network, representing patients infrequently included in large scale research networks. Parkland's cervical cancer screen-eligible population of more than 78,000 adult women is 6 1% Hispanic, 24% African American, and 8% Non-Hispanic White. All are low-income and few have private insurance leading them to rely on public insurance or charity care. Thus, our patients represent the "traditionally underserved" groups experiencing cervical cancer disparities - higher incidence and mortality, and lower screening and HPV vaccination. Parkland delivers the full cervical cancer screening process (risk assessment, early detection, diagnostic evaluation, and treatment) through an integrated system of 11 neighborhood-based primary care clinics, 11 women's health centers, and specialty clinics (dysplasia, gynecology and oncology). All clinics share a comprehensive electronic medical record (EMR) through which eligibility for a test, test ordering, results, referrals, and treatmentis ascertainable electronically. Our Center will expand by adding a Cervical Screening Process Documentation Unit (SPDU) and a Cervical Research Core. The Cervical SPDU will: 1) harness Parkland's EMR to collect accurate data on the cervical cancer screening process at multiple levels including the patient, provider, clinic, system, and health policy, and 2) securely transfer de-identified data to the Statistical Coordinating Center, investigators in the Cervical Research Core will provide intellectual leadership to the PROSPR network by prioritizing, conceptualizing, and conducting collaborative projects that capitalize on the heterogeneity of the network with respect to patient population, health system, and context. Data contributed by the Parkland-UT Southwestern PROSPR Center to the Network will enable analyses that examine how recent changes in guidelines and newly available screening and vaccine technologies impact long-standing disparities in cervical cancer. This research will improve both the science and delivery of effective cervical cancer screening.