title: Cancer screening practices among physicians in the national breast and cervical cancer early detection program.
abstract: BACKGROUND
  The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides low-income, uninsured women with screening and diagnostic services for breast and cervical cancer. Our study was conducted to describe the demographic and practice characteristics of participating and nonparticipating physicians, as well as their beliefs, adoption of new screening technologies, and recommendations for breast and cervical cancer screening.
  
  
  METHODS
  From a 2006-2007 nationally representative survey, we identified 1,111 practicing primary care physicians who provide breast and cervical cancer screenings and assessed their recommendations using clinical vignettes related to screening initiation, frequency, and cessation. Responses of physicians participating in the NBCCEDP were compared with those from nonparticipating physicians.
  
  
  RESULTS
  Of the physicians surveyed, 15% reported participation in the NBCCEDP, 65% were not participants, and 20% were not sure or did not respond to this question. Program physicians were significantly more likely to practice in multispecialty settings, in a rural location, and in a hospital or clinic setting and had more patients who were female and insured by Medicaid or uninsured compared with nonprogram physicians. Beliefs about the effectiveness of screening tools or procedures in reducing breast or cervical cancer mortality were similar by program participation. Adoption of new technologies, including digital mammography and human papillomavirus (HPV) testing, and making guideline-consistent recommendations for screening initiation, frequency, and cessation did not differ significantly by program participation.
  
  
  CONCLUSIONS
  Although there may be differences in physician characteristics and practice settings, the beliefs and screening practices for both breast and cervical cancer are similar between program and nonprogram providers.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. vbenard@cdc.gov
authors.forename: Vicki B
authors.initials: VB
authors.lastname: Benard
authors.forename: Mona S
authors.initials: MS
authors.lastname: Saraiya
authors.forename: Ashwini
authors.initials: A
authors.lastname: Soman
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Roland
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
authors.forename: Jackie
authors.initials: J
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult