PERIODIC HEALTH EXAMINATIONS AND THE PROVISION OF CANCER PREVENTION SERVICES

Objectives: To learn about cancer prevention services in primary care practices and to understand physician factors that affect the provisio n of these services. Design: Survey of physicians and their patients i n 1992. Setting: Cooperating physicians (n=72) of a random selection o f community general internist and family physician practices in New Ha mpshire and Vermont. Patients: Patients (n=2775) of the study physicia ns for at least 1 year, aged 42 years or older, with no life-threateni ng illness, who recently visited the physician. Main Outcome Measures: Proportion of sample patients per practice provided age- and sex-appr opriate cancer prevention services in the previous year. Results: In t his primary care population, a high proportion of patients received ap propriate services in 1992. A periodic health examination within the p ast year was an important predictor for the receipt of many cancer pre vention services. Female physicians provided more periodic health exam inations than male physicians; internists provided more than family ph ysicians. Conclusions: The strongest determinant of receiving preventi ve services is having a periodic health examination. If clinicians and policymakers decrease emphasis on the periodic health examination as a major opportunity to provide indicated preventive services, they sho uld ensure that a satisfactory alternative strategy is in place.