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Preventive health examination in cancer screening

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Authors:
Summary:

This retrospective cohort study (n =64,288) examined the association between receiving periodic health examinations (PHEs) and cancer testing; including colorectal cancer testing (fecal occult blood testing, sigmoidoscopy, colonoscopy, or barium enema), screening mammography, and prostate-specific antigen testing. PHEs were received by approximately half (52.4%) of the subjects and were significantly associated with cancer testing (following adjustment for confounders including demographics, comorbidity, number of outpatient visits, and historical preventive service use). Receipt of a PHE was significantly associated with completion of colorectal cancer testing (incidence difference, 40.4% [95% CI, 39.4-41.3%]; relative incidence, 3.47 [95% CI, 3.34-3.59]), screening mammography [incidence difference, 14.2% [95% CI 12.7-15.7%]; relative incidence, 1.23 [95% CI 1.20-1.25]), and prostate-specific antigen testing (incidence difference, 39.4% [95% CI 38.3-40.5%]; relative incidence, 3.06 [95% CI 2.95-3.18]). In conclusion receiving a PHE was associated with completion of colorectal, breast, and prostate cancer testing.

Comment:
There are a number of important messages from this study: 1. Periodic physical health examinations or ‘well health checks’ are associated with better rates of cancer screening 2. The checks must be undertaken regularly and not just at enrolment 3. Although this study only looked at cancer screening, there is evidence that similar checks as part of the annual diabetic review or secondary prevention for CVD benefit Mäori 4. Services that provide periodic health examinations must monitor for ethnic differences to ensure that Mäori are receiving checks at similar rates and that outcomes are equitable.
Reference: Arch Intern Med. 2007; 167:580-585
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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