Current cancer-screening practices in primary care vary significantly, may not follow evidence-based practices, and may not be targeting patients considered most at risk.
To determine actual rates of cancer screening in the primary-care setting, Kathryn J. Martires, MD, and co-investigators analyzed data from the National Ambulatory Medical Care Survey on 8,521 adult visits for preventive care made to office-based physicians from 2005 through 2010.
The team calculated prevalence rates for breast, pelvic, and rectal examinations as well as rates for mammograms, prostate-specific antigen (PSA) tests, and Pap tests.
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As reported in the journal Cancer, the rates of most screening examinations and tests were stable over time. Clinical breast examinations were conducted significantly more than mammography was ordered. White patients received more mammography, skin examinations, digital rectal examinations, and PSA tests than did patients of other races. The results demonstrated that racial and socioeconomic disparities are present in cancer screening in primary care.
In another development involving cancer screening in primary care, the United States Preventive Services Task Force (USPSTF) has found insufficient evidence to recommend for or against screening for oral cancer in asymptomatic adults in the primary-care setting. Oral cancer is predominantly caused by tobacco and alcohol use.
In Annals of Internal Medicine, Virginia A. Moyer, MD, stated that the USPSTF found inadequate evidence that screening for oral cancer and treatment of screen-detected oral cancer improves morbidity or mortality. However, the group also found inadequate evidence of the harms of screening
