Promoting cancer prevention activities by primary care physicians: results of a randomized, controlled trial

Article Abstract:

Cancer directly affects almost one third of the population at sometime during their lives and it is the second leading cause of death, responsible for one fifth of all deaths. Cancer of the lungs, breasts, and the colorectal area are the most prevalent and also cause a great number of cancer-related deaths. The National Cancer Institute (NCI) and the American Cancer Society (ACS) have both promoted screening for early detection and preventive measures to reduce the mortality from these cancers. These include changes in life style such as dietary and smoking habits, and undergoing regular screening. The success of such programs lies with the primary care physicians, who are in a position to encourage their patients to undergo screening and to make life-style changes. A number of methods for encouraging physicians to engage in cancer prevention activities have been proposed. This study examined the effectiveness of a computerized reminder program for physicians designed to encourage the use of cancer prevention activities. Forty physicians were randomly assigned either to a group receiving the computer reminders or to a group not receiving them. Each physician's use of cancer prevention activities was measured before and after the intervention. Prior to intervention, scores ranged from 1.3 percent for dietary counseling to 113.4 percent for Pap smears. (Percentages reflect the physician's performance of tests compared with standards set by the ACS and NCI, for age and screening interval.) After the intervention with the computer reminder system, the physicians in the reminder group scored significantly higher on performance scores for a number of preventive activities than did the control group. This included higher scores for stool occult-blood test, rectal examination, Pap smear, pelvic examination, smoking assessment and counseling, and dietary assessment and counseling. These results indicate that the computer reminder system can significantly improve a physician's use of cancer prevention measures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Public relations, Patient education, Physicians (General practice), General practitioners, Health counseling, Cancer education

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Misconceptions about cancer among Latinos and Anglos

Article Abstract:

Hispanic Americans are more likely than their Anglo counterparts to have a fatalistic attitude about cancer and to have less knowledge about the risks and symptoms of cancer. In a survey of 844 Latinos and 510 Anglos, all members of the same prepaid health plan, significantly more Latinos thought sugar substitutes, bruises, microwave ovens, pork meat, spicy foods, breast milk and antibiotics were causes of cancer. More Latinos incorrectly viewed prolonged dizziness and painful joints as cancer symptoms. Latinos hold negative conceptions of cancer as being a death sentence, something to avoid talking about and a form of punishment from God. A better understanding of Hispanic Americans' awareness and fears of cancer may assist the medical profession in addressing their specific health needs and concerns.

Beliefs, opinions and attitudes, Public opinion, Cancer, Hispanic Americans, Anglo-Americans, English Americans

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Integrating palliative care for liver transplant candidates

Article Abstract:

Patients waiting for liver transplant sometimes succumb to the complications of the transplant itself while those who had liver transplant live with the uncertainty of having a potentially treatable, yet often fatal, illness. To maximize these patients' quality and quantity of life, palliative care and life-sustaining therapy must be delivered in combination.

United States, Complications and side effects, Palliative care, Liver transplantation

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