Abstract 17062: Adequacy of Primary Care Screening of Women with Adult Congenital Heart Disease
Introduction: Adults with congenital heart disease (ACHD) face non-cardiac healthcare challenges as the population ages. The 2008 ACC/AHA guidelines called for every ACHD patient to have a primary care physician and receive preventive screening, often underemphasized in chronic disease populations.
Hypothesis: We assessed the hypothesis that women with ACHD have lower compliance rates for preventive screening compared with control subjects seen in a cardiac practice and with norms in the US population.
Methods: IRB approved retrospective review of females over age 18 years seen in a cardiac care center in 2009-2011. Data on history, Pap smears, mammograms, colonoscopy, and bone densitometry were obtained from medical records. Adequacy of screening was defined according to US guidelines (as of November 2009).
Results: We reviewed data of 164 women with ACHD, with 89 women meeting criteria with adequate data, and compared with 39 age-matched control subjects. Women with ACHD had lower rates of preventive screening compared with controls (p < 0.001 for comparison across 4 screening categories, see Table 1). Compliance rates of both groups with colonoscopies were better than nationwide statistics, surpassing the Healthy People 2010 target. Women with ACHD had low screening rates for cervical cancer, breast cancer, and osteoporosis, below national averages. Follow-up for abnormal results was adequate, with lowest rates of follow up for colonoscopies. Individuals with “moderate” ACHD per Bethesda conference guidelines had the lowest rates of adequate screening (37%) compared with simple (50%) or complex (47%) disease patients.
Conclusions: Women with ACHD need increased primary care screening with Pap smears, mammograms, and DEXA scans. Primary care physicians, cardiologists, and gynecologists should collaborate to ensure appropriate health maintenance screening for this growing and aging patient population.
- © 2011 by American Heart Association, Inc.