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 provision of these services. Design: Survey of physicians and their patients in 1992. Setting: Cooperating physicians (n=72) of a random selection of community general internist and family physician practices in New Hampshire and Vermont. Patients: Patients (n=2775) of the study physicians for at least 1 year, aged 42 years or older, with no life-threatening illness, who recently visited the physician. Main Outcome Measures: Proportion of sample patients per practice provided age- and sex-appropriate cancer prevention services in the previous year. Results: In this primary care population, a high proportion of patients received appropriate services in 1992. A periodic health examination within the past year was an important predictor for the receipt of many cancer prevention services. Female physicians provided more periodic health examinations than male physicians; internists provided more than family physicians. Conclusions: The strongest determinant of receiving preventive 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 should ensure that a satisfactory alternative strategy is in place.