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UC Davis Health System

UC Davis Health System

Checkup on health: Regular checkups lead to needed cancer screenings

Male patient receiving medical exam from doctorIf you're 50 or older, seeing your doctor every year or two for a checkup may be a good defense against cancer. Regular preventive health exams increase the likelihood that older adults will get recommended cancer screenings.

"Because people go to the doctor anyway when they feel sick or have a medical problem, some authorities have questioned whether preventive, or general, health examinations are worth the extra time and effort," said Joshua Fenton, an assistant professor of family and community medicine at UC Davis who has researched the topic.

"Our study suggests they are," Fenton said. "If people over 50 have checkups every year or two, they're more likely to go ahead and get the cancer screenings they need."

In 2007, Fenton and colleagues at the University of Washington and Group Health Cooperative in Seattle studied patients ages 52 to 78 years old who were eligible for breast, colon or prostate cancer screening in 2002 and 2003 through Group Health Cooperative. Group Health is a large, prepaid group health plan in Seattle. The researchers then sorted the patients into two groups: those who had a preventive health exam or general physical during the two-year period and those who didn't. Finally, the researchers compared cancer screening rates between the two groups.

The study included 64,288 patients. About half had a preventive health exam during the two-year period, and half didn't. (Group Health recommends patients get an exam every two years, but doesn't send reminders.)

Dr. Joshua Fenton"If people over 50 have checkups every year or two, they're more likely to go ahead and get the cancer screenings they need."
—Joshua Fenton, physician and researcher

A clear screening gap emerged: Patients who had a general checkup were more than three times as likely as those who didn't to get some type of colon cancer screening. Colon screenings included fecal occult blood testing, sigmoidoscopy, colonoscopy and barium enema.

Patients who got checkups were also about three times as likely to get a prostate-specific antigen, or PSA, test for prostate cancer.

Mammography rates were higher in the checkup group as well, but by a lesser margin, probably because Group Health sends reminders to all women who are due for a mammogram.

The screening gaps persisted regardless of how many "illness" visits patients had during the study period, suggesting doctors may not have time to advocate for cancer screening when they're evaluating a sick patient. Other evidence supports this view: Fenton notes that one recent survey found 97 percent of primary care physicians said they recommend appropriate cancer screening to patients during preventive visits, but few bring up the subject during other visits.

"The preventive health exam may be an auspicious time to promote cancer screening,” Fenton said. “These visits may afford primary care physicians the opportunity to discuss and recommend cancer screening when indicated, and physicians' recommendations have been consistently associated with timely cancer screening."

The study appeared in the March 26, 2007, issue of Archives of Internal Medicine. It was supported by grants from the National Cancer Institute and the American Cancer Society.