Delivery of cancer screening

How important is the preventive health examination?

Joshua J Fenton, Yong Cai, Noel S. Weiss, Joann G. Elmore, Roy E. Pardee, Robert J. Reid, Laura Mae Baldwin

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)580-585
Number of pages6
JournalArchives of Internal Medicine
Volume167
Issue number6
DOIs
StatePublished - Mar 26 2007

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Early Detection of Cancer
Colorectal Neoplasms
Confidence Intervals
Health
Incidence
Breast Neoplasms
Prostatic Neoplasms
Mammography
Prostate-Specific Antigen
State Health Plans
Sigmoidoscopy
Occult Blood
Managed Care Programs
Colonoscopy
Population
Comorbidity
Cohort Studies
Outpatients
Retrospective Studies
Demography

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Fenton, J. J., Cai, Y., Weiss, N. S., Elmore, J. G., Pardee, R. E., Reid, R. J., & Baldwin, L. M. (2007). Delivery of cancer screening: How important is the preventive health examination? Archives of Internal Medicine, 167(6), 580-585. https://doi.org/10.1001/archinte.167.6.580

Delivery of cancer screening : How important is the preventive health examination? / Fenton, Joshua J; Cai, Yong; Weiss, Noel S.; Elmore, Joann G.; Pardee, Roy E.; Reid, Robert J.; Baldwin, Laura Mae.

In: Archives of Internal Medicine, Vol. 167, No. 6, 26.03.2007, p. 580-585.

Research output: Contribution to journalArticle

Fenton, JJ, Cai, Y, Weiss, NS, Elmore, JG, Pardee, RE, Reid, RJ & Baldwin, LM 2007, 'Delivery of cancer screening: How important is the preventive health examination?', Archives of Internal Medicine, vol. 167, no. 6, pp. 580-585. https://doi.org/10.1001/archinte.167.6.580
Fenton, Joshua J ; Cai, Yong ; Weiss, Noel S. ; Elmore, Joann G. ; Pardee, Roy E. ; Reid, Robert J. ; Baldwin, Laura Mae. / Delivery of cancer screening : How important is the preventive health examination?. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 6. pp. 580-585.
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abstract = "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.",
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AU - Cai, Yong

AU - Weiss, Noel S.

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AU - Pardee, Roy E.

AU - Reid, Robert J.

AU - Baldwin, Laura Mae

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N2 - 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.

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