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Recommendation for and receipt of cancer screenings among Medicaid recipients 50 years and older
Archives of Internal Medicine, 10/17/08

DuBard CA et al. – Cancer screening rates among older Medicaid recipients are short of national objectives; most cases of screening delinquency are due to lack of a physician's screening recommendation, rather than pt refusal of recommended tests

Methods

Study to identify cancer screening rates among older Medicaid pts in a primary care setting and to identify pt and physician characteristics associated with screening
Use of stratified cluster sampling design to sample 1951 Medicaid recipients age ≥50 yrs
Medical records review in primary care office
Principal outcomes: documentation of physician recommendations for and pt receipt of screening examinations for colorectal, breast, and cervical cancer

Results

Documentation of primary care provide-recommended colorectal, breast, and cervical cancer screening: for 52.7%, 60.4%, and 51.5% of eligible pts, respectively
Documented rates of adequate screening: 28.2%, colorectal cancer; 31.7%, mammography within 2 yrs; 31.6%, Papanicolaou test within 3 yrs
When medical record and claims data were combined, approximately 50% of eligible pts had evidence of screening
Length of pt-physician relationship and African American race positively associated with screening

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