title: The delivery of preventive services in primary care practices according to chronic disease status.
abstract: OBJECTIVE
  The current study examined the relationship between chronic disease status and the receipt of cancer preventive services over a 3-year period.
  
  
  METHODS
  Adults (n = 4320) cared for by 167 nonacademic physicians in 42 primary care group practices were studied. Medical records were audited for each patient, as were patient responses to two questionnaires assessing health and sociodemographic characteristics.
  
  
  RESULTS
  While the odds of having received counseling to obtain regular checkups were increased for men (1.56) and women (1.46) with hypertension, the odds were reduced (range = 0.32 to 0.81) for having received a sigmoidoscopy (women with diabetes or hypertension, men with hypertension or heart disease), fecal occult blood test (men with diabetes or heart disease, women with heart disease), mammogram or counseling about smoking (women with diabetes), clinical breast exam (women with heart disease), and Pap test (women with diabetes or heart disease).
  
  
  CONCLUSIONS
  The presence of common chronic health problems in older adults is associated with lower levels of cancer screening services.
authors.affiliation: School of Nursing, University of Wisconsin, Milwaukee 53201, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Fontana
authors.forename: L C
authors.initials: LC
authors.lastname: Baumann
authors.forename: C
authors.initials: C
authors.lastname: Helberg
authors.forename: R R
authors.initials: RR
authors.lastname: Love
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D009369:Neoplasms / Q000517:prevention & control*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012494:Sampling Studies