title: The association of type and number of chronic diseases with breast, cervical, and colorectal cancer screening.
abstract: OBJECTIVE
  The purpose of this study was to examine associations between the number and types of patients' chronic diseases and being up to date for breast, cervical, and colorectal cancer screening.
  
  
  METHODS
  Data were abstracted from medical charts at 4 primary care clinics located in 2 rural Oregon communities. Eligibility criteria included being at least 55 years old and having at least 1 clinic visit in the past 2 years.
  
  
  RESULTS
  Of 3433 patients included, 503 (15%) had no chronic illness, 646 (19%) had 1, 786 (23%) had 2, and 1498 (44%) had ≥3 chronic conditions. Women with asthma/chronic lung disease and with cardiovascular disease were less likely to be up o date for mammography screening (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.43-0.80), and those with chronic digestive disorders were more likely to be up to date for mammography (OR, 1.31; 95% CI, 1.03-1.66) compared with those without chronic conditions. Women with arthritis, diabetes mellitus, and hypertension were less likely to be up to date for cervical cancer screening (OR, 0.38; 95% CI, 0.21-0.68) compared with those without chronic conditions. Men with cardiovascular disease were less likely to be up to date for colorectal cancer screening (adjusted OR, 0.59; 95% CI, 0.44-0.80), and women with depression were less likely to be up to date (OR, 0.71; 95% CI, 0.56-0.91) compared with men and women without chronic conditions.
  
  
  CONCLUSIONS
  Specific chronic conditions were found to be associated with up-to-date status for cancer screening. This finding may help practices to identify patients who need to receive cancer screening.
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: Betty Y
authors.initials: BY
authors.lastname: Liu
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: Jean
authors.initials: J
authors.lastname: O'Malley
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: Motomi
authors.initials: M
authors.lastname: Mori
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Fagnan
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: David
authors.initials: D
authors.lastname: Lieberman
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Morris
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: David I
authors.initials: DI
authors.lastname: Buckley
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland.
authors.forename: John D
authors.initials: JD
authors.lastname: Heintzman
authors.affiliation: From the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (BYL); the Department of Public Health and Preventive Medicine, Division of Biostatistics (JO, MM), the Department of Family Medicine (LJF, DIB, JDH, PAC), the Department of Internal Medicine, Division of Gastroenterology (CDM), the Department of Medical Informatics and Clinical Epidemiology (CDM, DIB), and the Department of Public Health and Preventive Medicine (DIB, PAC) Oregon Health & Science University, Portland. carneyp@ohsu.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D009922:Oregon; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology
keywords: Cancer Screening; Chronic Disease; Rural Health