title: Patterns of cancer screening in primary care from 2005 to 2010.
abstract: BACKGROUND
  Cancer screening recommendations vary widely, especially for breast, prostate, and skin cancer screening. Guidelines are provided by the American Cancer Society, the US Preventive Services Task Force, and various professional organizations. The recommendations often differ with regard to age and frequency of screening. The objective of this study was to determine actual rates of screening in the primary care setting.
  
  
  METHODS
  Data from the National Ambulatory Medical Care Survey were used. Only adult visits to non-federally employed, office-based physicians for preventive care from 2005 through 2010 were examined. Prevalence rates for breast, pelvic, and rectal examinations were calculated, along with the rates for mammograms, Papanicolaou smears, and prostate-specific antigen tests. Factors associated with screening, including age, race, smoking status, and insurance type, were examined using t tests and chi-square tests.
  
  
  RESULTS
  In total, 8521 visits were examined. The rates of most screening examinations and tests were stable over time. Clinical breast examinations took place significantly more than mammography was ordered (54.8% vs 34.6%; P<.001). White patients received more mammography (P=.031), skin examinations (P<.010), digital rectal examinations (P<.010), and prostate-specific antigen tests (P=.003) than patients of other races. Patients who paid with Medicare or private insurance received more screening than patients who had Medicaid or no insurance (P<.010).
  
  
  CONCLUSIONS
  Current cancer screening practices in primary care vary significantly. Cancer screening may not follow evidence-based practices and may not be targeting patients considered most at risk. Racial and socioeconomic disparities are present in cancer screening in primary care.
authors.affiliation: Department of Graduate Medical Education, Scripps Mercy Hospital, San Diego, California; Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Martires
authors.forename: David E
authors.initials: DE
authors.lastname: Kurlander
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Minwell
authors.forename: Eric B
authors.initials: EB
authors.lastname: Dahms
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Bordeaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D051517:Digital Rectal Examination; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008327:Mammography; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D011320:Primary Health Care; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D012878:Skin Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D017430:Prostate-Specific Antigen
keywords: breast cancer; cancer screening; cervical cancer; melanoma; primary care; prostate cancer; skin cancer