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Side Effect of Regular
Preventive Health Exams: More Mammograms and Colonoscopies
Newswise — If you’re 50 or older, seeing your
doctor every year or two for a checkup may be a good defense against
cancer, according to a new study by researchers at UC Davis, the
University of Washington, and Group Health Cooperative in Seattle.
The study, to appear in the
March 26 issue of Archives of Internal Medicine,
concluded that regular preventive health exams
increase the likelihood that older adults will get
recommended cancer screenings.
“Because people go to the doctor anyway when
they feel sick or have a medical problem, some authorities have
questioned whether preventive, or general, health examinations are
worth the extra time and effort,” said lead author Joshua Fenton,
assistant professor of family and community medicine at UC Davis.
“Our study suggests they are. If people over 50
have checkups every year or two, they’re more likely to go ahead and
get the cancer screenings they need."
Fenton and his colleagues focused their study
on patients ages 52 to 78 years old who were eligible for breast,
colon or prostate cancer screening in 2002 and 2003 through Group
Health Cooperative. Group Health is a large, prepaid group health
plan in Seattle. The researchers then sorted the patients into two
groups: those who had a preventive health exam or general physical
during the two-year period and those who didn’t. Finally, the
researchers compared cancer screening rates between the two groups.
The study included 64,288 patients. About half
had a preventive health exam during the two-year period, and half
didn’t. (Group Health recommends patients get an exam every two
years, but doesn’t send reminders).
A clear screening gap emerged: Patients who had
a general checkup were more than three times as likely as those who
didn’t to get some type of colon cancer screening. Colon screenings
included fecal occult blood testing, sigmoidoscopy, colonoscopy and
barium enema.
Patients who got checkups were also about three times as likely to
get a prostate-specific antigen, or PSA, test for prostate cancer.
Mammography rates were higher in the checkup
group as well, but by a lesser margin, probably because Group Health
sends reminders to all women who are due for a mammogram.
The screening gaps persisted regardless of how
many “illness” visits patients had during the study period,
suggesting doctors may not have time to advocate for cancer
screening when they’re evaluating a sick patient.
Other evidence supports this view: Fenton notes
that one recent survey found 97 percent of primary care physicians
said they recommend appropriate cancer screening to patients during
preventive visits, but few bring up the subject during other visits.
“The preventive health exam may be an
auspicious time to promote cancer screening,” Fenton said. “These
visits may afford primary care physicians the opportunity to discuss
and recommend cancer screening when indicated, and physicians’
recommendations have been consistently associated with timely cancer
screening.”
The study was supported by grants from the
National Cancer Institute and the American Cancer Society
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