title: Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians.
abstract: BACKGROUND
  Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians' ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations.
  
  
  METHODS
  Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n = 26,716).
  
  
  RESULTS
  In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p < 0.0001 for provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p < 0.01 for provider type).
  
  
  CONCLUSIONS
  Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform.
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA. deanna.kepka@hci.utah.edu.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kepka
authors.forename: Alexandria
authors.initials: A
authors.lastname: Smith
authors.forename: Christopher
authors.initials: C
authors.lastname: Zeruto
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
mesh_terms: D001291:Attitude of Health Personnel; D055088:Early Detection of Cancer; D006801:Humans; D008403:Mass Screening; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D009726:Nurses / Q000523:psychology; D010349:Patient Compliance; D058991:Patient Protection and Affordable Care Act; D010823:Physician Assistants / Q000523:psychology; D058007:Physicians, Primary Care; D012907:Smoking