The delivery of preventive services in primary care practices according to chronic disease status

Objectives. The current study examined the relationship between chronic-disease status and the receipt of cancer preventive services over a 3-year period. Methods. Adults (n = 4320) cared for by 167 nonacademic physicians in 42 primary care group practices were studied. Medical records were audited for each patient, as wee patient responses to two questionnaires assessing health and sociodemographic characteristics. Results. While the odds of having received counseling to obtain regular checkups were increased for men (1.56) and women (1.46) with hypertension, the odds were reduced (range = 0.32 to 0.81) for having received a sigmoidoscopy (women with diabetes or hypertension, men with hypertension or heart disease), fecal occult blood test (men with diabetes or heart disease, women with heart disease), mammogram or counseling about smoking (women with diabetes), clinical breast exam (women with heart disease), and Pap test (women with diabetes or heart disease). Conclusions. The presence of common chronic health problems in older adults is associated with lower levels of cancer screening services.