Using quality improvement to increase the awareness of obesity among endometrial cancer patients. Issue 6 (July 2019)

• Record Type: Journal Article
• Authors: Torres, Diogo; Shafa, Anousheh; Klennert, Sara; Hokenstad, Alexis; Bird, Megan; Weinhold, Megan; Mundi, Manpreet S; Langstraat, Carrie; Kumar, Amanika
• Is Part Of: International journal of gynecological cancer. Volume 29:Issue 6(2019)
• Publication Date: 2019-07
• Subjects: obesity -- endometrial cancer -- quality improvement -- weight loss -- bariatric surgery -- cancer survivorship; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2019-000495
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: To increase discussion about obesity and endometrial cancer and referrals to weight loss clinic in patients with newly diagnosed low-risk endometrial cancer. Methods: A multidisciplinary team used a quality improvement methodology to increase patient awareness about obesity and endometrial cancer. Target population included patients <80 years old with a body mass index ≥30 kg/m 2 who underwent surgery at our institution and had a final diagnosis of complex hyperplasia or stage I, grade 1–2 endometrioid endometrial cancer. A toolkit was developed for the intervention. Clinical characteristics, discussion about obesity, and referrals to a weight loss clinic were abstracted for a historic and intervention cohort. Data for the two cohorts were compared using chi-square, Fisher's exact test, and t-test. Results: 54 patients from the historic cohort and 53 from the intervention cohort met inclusion criteria. Clinical characteristics were balanced between the groups. Discussion about obesity increased from 11.1% (6/54) to 79.2% (42/53) after implementing the toolkit (p < 0.001). Referrals to the weight loss clinic also increased from 3.7% (2/54) to 26.4% (14/53) after implementing the toolkit (p=0.001), but in both groups only 50% of those referred actually attended the weight loss clinic. No clinical characteristics were identified as associated with being more likely to have documented conversations or referrals. Conclusions: A multidisciplinary quality-improvement project can be used to increase discussion about obesity and referral to a weight loss clinic in patients with low-risk endometrial cancer. Increasing patient awareness of the connection between obesity and endometrial cancer may have implications on the long-term health of endometrial cancer survivors.