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Systems Strategies To Support Cancer Screening in U.S. Primary Care Practice

Tue, Oct 11, 2011

Oral Cancer News

Cancer Epidemiol Biomarkers Prev. 2011 Oct 5

Yabroff R, Zapka JM, Klabunde C, Yuan G, Buckman D, Haggstrom D,  Clauser S, Miller JW, Taplin S.


Division of Cancer Control and Population Sciences, National Cancer  Institute.



Although systems strategies are effective in improving health care  delivery, little is known about their use for cancer screening in U.S. primary care practice.


We assessed primary care physicians’ (n=2475) use of systems strategies for breast, cervical and colorectal cancer (CRC) screening  in a national survey conducted in 2007. Systems strategies included patient and physician screening reminders, performance reports of screening rates, electronic medical records, implementation of  in-practice guidelines, and use of nurse practitioners/physician assistants. We evaluated use of both patient and physician screening reminders with other strategies in separate models by screening type, adjusted for the effects of physician and practice characteristics with multivariate logistic regression.


Fewer than 10% of physicians used a comprehensive set of systems strategies to support cancer screening; use was greater for mammography and Pap testing than for CRC screening. In adjusted analyses, performance reports of cancer screening rates, medical record type, and in-practice guidelines were associated with use of both patient and physician screening reminders for mammography, Pap testing, and CRC screening (p<0.05).


Despite evidence supporting use of systems strategies in primary care, few physicians report using a comprehensive set of strategies to support cancer screening. Impact: Current health policy initiatives underscore the importance of increased implementation of systems strategies in primary care to improve the use and quality of cancer screening in the U.S.

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One Response to “Systems Strategies To Support Cancer Screening in U.S. Primary Care Practice”

  1. Brian Hill Says:

    If we can’t count on the general medical population to even screen (using accepted protocols) for these other cancers, I guess we shouldn’t count on them to opportunistically look for (or even understand), one that is less common and requires them to learn something new… Sad. Another missed opportunity.

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