Women are more likely to undergo screening with Pap smears and mammograms if they see female rather than male physicians, particularly if the physician is an internist or family practitioner.
OBJECTIVE:To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity. DESIGN: Controlled trial. SETTING: Urban county teaching hospital.PARTICIPANTS: Women aged 40 years and over attending appointments in several non-primary-care outpatient clinics. INTERVENTIONS:Lay health advisers assessed the participants' breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner. MEASUREMENTS AND MAIN RESULTS:Screening rates at baseline and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group ( p ؍ .009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group ( p ؍ .02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group ( p ؍ .006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group ( p ؍ .002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women. CONCLUSIONS:Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.KEY WORDS: mass screening; vaginal smears; mammography; nurse practitioners; community health aides. J GEN INTERN MED 1998;13:515-521.S creening mammography and Pap smears have been shown convincingly to decrease breast and cervical cancer mortality. 1,2 Recent population-based surveys suggest progress toward the year 2000 goals in the general population for both breast and cervical cancer screening. 3,4 However, nonwhite women, older women, and those with lower incomes and less education generally have lower screening rates. [4][5][6] Strategies to improve screening rates in these groups are needed.Hennepin County Medical Center, the urban county teaching hospital in Minneapolis, serves many women from groups that are less likely to receive breast and cervical cancer screening. Preliminary reviews of the charts of women attending appointments in the general medicine clinic, medical subspecialty clinics, and surgical clinics, showed the lowest screening rates in women attending surgical clinics (K.L. Margolis, unpublished data). Primary care physicians have been urged to "put prevention into practice" with each patient contact, 7 but few specialists are prepared to utilize each patient contact this way. Physicianoriented interventions such as education, 8 feedback of screening rates, 9 checklists, 10,11 nurse-generated reminders, 12 and computer-generated reminders 9,13 have been modestly successful in increasing cancer screening in primary care setting...
The relation of leisure time and occupational physical activity to the risk of death from ischemic heart disease was investigated in a cohort of 15,088 persons aged 30-59 years who had no history of cardiovascular disease or other condition which hindered physical activity. Two population samples were randomly chosen from eastern Finland. During a six-year follow-up, persons who were sedentary in leisure time (relative risk = 1.3, 95% confidence interval (CI) = 1.1-1.6) or at work (relative risk = 1.3, 95% CI = 1.1-1.6) had an excess risk of ischemic heart disease death when adjusted for age, health status, family history, and body mass index in multivariate logistic models. Adjustment for years of education, social network participation, cigarette consumption, serum cholesterol level, and blood pressure level weakened the residual association of low leisure time physical activity with the risk of ischemic heart disease death (relative risk = 1.2, 95% CI = 1.0-1.5), whereas the association for low occupational physical activity remained unchanged. The lack of leisure time physical activity and a sedentary occupation are associated with an increased risk of ischemic heart disease death, and the excess risk due to lack of leisure time physical activity is, in part, accounted for by other ischemic heart disease risk factors.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.