Article Figures & Data
Tables
Control Intervention Clinical Characteristics No. % No. % PValue *Among patients who were eligible. Group 596 49.8 600 50.2 Sex .88 Male 129 21.6 132 22.0 Female 467 78.4 468 78.0 Age, years .38 50–56 212 35.6 232 38.7 57–63 196 32.9 199 33.1 64–75 188 31.5 169 28.3 Race-ethnicity .0009 African American 144 24.2 204 34.0 White 307 51.5 272 45.3 Hispanic 145 24.3 124 20.7 Marital status .003 Married 142 23.8 189 31.5 Unmarried 454 76.2 411 68.5 Primary language .23 English 464 77.8 484 80.7 Non-English (Spanish) 132 22.2 116 19.3 Health insurance .48 County program 354 59.4 346 57.7 Medicaid 83 13.9 101 16.8 Medicare 122 20.5 112 18.7 Other 37 06.2 41 06.8 Smoking status .61 Smoker 163 27.4 172 28.7 Nonsmoker 433 72.6 428 71.3 Health maintenance visit in past year .16 Yes 329 55.2 307 48.8 No 267 44.8 293 51.2 Charlson comorbidity score <.0001 0 249 41.8 175 29.2 1 129 21.7 146 24.3 2 120 20.1 156 26.0 >3 98 16.4 123 20.5 Chronic illnesses <.0001 0–4 214 35.9 127 21.2 5–7 233 39.1 235 39.2 > 8 149 25.0 238 39.6 Medications prescribed <.0001 0–5 272 45.6 110 18.3 6–8 182 30.5 153 25.5 > 9 142 23.8 337 56.2 Health care visits in past year <.0001 0–4 213 35.7 150 25.0 5–7 185 31.0 185 30.8 > 8 198 33.2 265 44.2 Papanicolaou smear in past year* .33 Yes 148 57.6 151 61.9 No 109 42.4 93 38.1 Mammogram in past year* .13 Yes 337 75.9 325 71.4 No 107 24.1 130 28.6 Fecal occult blood test in past year* <.0001 Yes 109 22.1 180 35.9 No 384 77.9 321 64.1 Screening Test Number Odds Ratio 95% CI PValue CI = confidence interval. Papanicolaou smears 1,057 1.57 0.92–2.64 .096 Mammograms 1,832 1.62 1.07–9.78 .023 Fecal occult blood test 1,989 2.56 1.65–4.01 <.0001
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The Article in Brief
Racial and ethnic minorities, low-income persons, and those who are uninsured or insured by Medicaid are more likely to have poor cancer outcomes. This may be due, in part, to lower use of screening tests. The "Cancer Screening Office Systems" program--a low-cost, non-computerized program--increased the use of screening tests in primary care practices serving these groups. The program focused on 3 cancer-screening tests: mammograms, Pap smears, and fecal occult blood tests (a test for digestive system problems including colon cancer). As part of the program, patients completed a checklist about when they last received cancer-screening tests. The medical office used a series of stickers on medical records to show whether cancer-screening tests were due, ordered, or completed. In addition, office staff members were assigned specific roles in carrying out the program.
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