 |
|
Delivery of Cancer ScreeningHow Important Is the Preventive Health Examination?
Joshua J. Fenton, MD, MPH;
Yong Cai, PhD;
Noel S. Weiss, MD, DrPH;
Joann G. Elmore, MD, MPH;
Roy E. Pardee, JD, MA;
Robert J. Reid, MD, PhD;
Laura-Mae Baldwin, MD, MPH
Arch Intern Med. 2007;167(6):580-585.
Background Patients and physicians strongly endorse the importance of preventive or periodic health examinations (PHEs). However, the extent to which PHEs contribute to the delivery of cancer screening is uncertain.
Methods In a retrospective cohort study, we determined the association between receipt of a PHE and cancer testing in a population-based sample of enrollees in a Washington State health plan who were aged 52 to 78 years and eligible for colorectal, breast, or prostate cancer screening in 2002-2003 (N = 64 288). Outcomes included completion of any colorectal cancer testing (fecal occult blood testing, sigmoidoscopy, colonoscopy, or barium enema), screening mammography, and prostate-specific antigen testing.
Results More than half (52.4%) of the enrollees received a PHE during the study period. After adjusting for demographics, comorbidity, number of outpatient visits, and historical preventive service use before January 1, 2002, receipt of a PHE was significantly associated with completion of colorectal cancer testing (incidence difference, 40.4% [95% confidence interval (CI), 39.4%-41.3%]; relative incidence, 3.47 [95% CI, 3.34-3.59]), screening mammography [incidence difference, 14.2% [95% CI, 12.7%-15.7%]; relative incidence, 1.23 [95% CI, 1.20-1.25]), and prostate-specific antigen testing (incidence difference, 39.4% [95% CI, 38.3%-40.5%]; relative incidence, 3.06 [95% CI, 2.95-3.18]).
Conclusions Among managed care enrollees eligible for cancer screening, PHE receipt is associated with completion of colorectal, breast, and prostate cancer testing. In similar populations, the PHE may serve as a clinically important forum for the promotion of evidence-based colorectal cancer and breast cancer screening and of screening with relatively less empirical support, such as prostate cancer screening.
Author Affiliations: Department of Family and Community Medicine, University of California, Davis, Sacramento (Dr Fenton); Departments of Family Medicine (Drs Cai and Baldwin), Epidemiology (Drs Weiss and Elmore), and Medicine (Dr Elmore), University of Washington, Seattle; and Center for Health Studies (Mr Pardee and Dr Reid) and Department of Preventive Medicine (Dr Reid), Group Health Cooperative, Seattle.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Impact of Age and Comorbidity on Colorectal Cancer Screening Among Older Veterans
Walter et al.
ANN INTERN MED 2009;150:465-473.
ABSTRACT
| FULL TEXT
Influence of Primary Care Use on Population Delivery of Colorectal Cancer Screening
Fenton et al.
Cancer Epidemiol. Biomarkers Prev. 2009;18:640-645.
ABSTRACT
| FULL TEXT
Cancer screening in the United States, 2009: A review of current American Cancer Society guidelines and issues in cancer screening
Smith et al.
CA Cancer J Clin 2009;59:27-41.
ABSTRACT
| FULL TEXT
Cancer Screening in the United States, 2008: A Review of Current American Cancer Society Guidelines and Cancer Screening Issues
Smith et al.
CA Cancer J Clin 2008;58:161-179.
ABSTRACT
| FULL TEXT
Preventive Health Examinations and Preventive Gynecological Examinations in the United States
Mehrotra et al.
Arch Intern Med 2007;167:1876-1883.
ABSTRACT
| FULL TEXT
|
