Early detection and control of cancer in clinical practice

Article Abstract:

Most physicians do not screen for cancer or provide preventive care for patients without symptoms. The lack of consistent medical screening may be related to the organization of medical care, the risk status of the patient, the personal experience of the physician, or the physician's stage of medical training. Reasons given by doctors for not performing screening procedures include patient fearfulness or refusal, physician forgetfulness and busyness, and the complicated nature of the procedure. The Community Cancer Care Evaluation (CCCE) of the Community Clinical Oncology Program (CCOP) at the National Cancer Institute examined physician performance of six cancer screening and early detection procedures. These included chest X-ray, rectal examination, examination of stools for blood using a resin called guaiac, physical and X-ray examination of the breast, and a complete physical examination. The CCCE surveyed practicing physicians in 12 geographic locations regarding physician practice patterns for cancer detection, control, and treatment. Physicians were asked whether they performed these screening procedures routinely on normal healthy patients older than 50 years. The results showed that the geographic area, specific procedure, and specialty of the physician influenced whether recommendations of the American Cancer Society and National Cancer Institute were followed. The frequency of performing all screening procedures varied with time elapsed since medical school graduation, and recent graduates were more likely to follow standards for recommended screening procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Cancer, Preventive health services, Preventive medicine, Cancer diagnosis

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Health promotion and disease prevention in the elderly: comparison of house staff and attending physician attitudes and practices

Article Abstract:

The attitudes and practices of attending physicians and house staff were assessed in relation to health promotion and disease prevention in the elderly. Thirty-eight house staff and 36 attending physicians were surveyed to evaluate their agreement with recommendations made by the American Cancer Society and the Canadian Task Force that suggested more frequent screening, immunization, and counseling for health risk factors among older as compared with younger adults. In addition, 250 patients were interviewed and their medical records were examined to determine if the recommendations were followed. Physicians agreed strongly with the recommendations of the American Cancer Society and the Canadian Task Force, with the exception of recommendations concerning proctoscopy, examination of the rectum using an instrument, and thyroid examinations. But the physicians actually performed the screening tests much less frequently than their opinions would indicate. House staff and attending physicians differed with regard to their attitudes on disease prevention. House staff encouraged a healthy lifestyle and commitment to health promotion. The probability that a physician would order a medical test or examination was influenced by certain factors, including the presence of a checklist, site of practice, and physician status. In conclusion, although all physicians agreed with screening, it was unlikely that attending physicians and house staff would perform the screening in the elderly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Aged, Elderly, Evaluation, Health promotion

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