Smoking history and adherence to cancer-related recommendations in a primary care setting. Issue 2 (16th December 2021)

• Record Type: Journal Article
• Authors: Zoorob, Roger J; Mejia, Maria C; Matas, Jennifer; Wang, Haijun; Salemi, Jason L; Levine, Robert
• Is Part Of: Translational behavioral medicine. Volume 12:Issue 2(2022)
• Page Start: 362
• Page End: 367
• Publication Date: 2021-12-16
• Subjects: Cancer screening recommendations -- Smoking status -- Nonadherence -- Cancer prevention; Medicine and psychology -- Periodicals; 616.0019
• DOI: 10.1093/tbm/ibab156
• Languages: English
• ISSNs: 1869-6716

Abstract

Abstract: Public health prevention efforts have led to overall reductions in mortality from screening-preventable cancers. We explored cancer screening behaviors of smokers, former smokers, and nonsmokers among patients of large primary care practices to discover the relationship between smoking status and previous adherence to the United States Preventive Services Task Force breast, cervical, and colorectal cancer screening recommendations. Our descriptive study of electronic medical record data included 6, 029 established primary care patients. Multi-predictor log-binomial regression models yielded prevalence ratios (PRs) and 95% confidence intervals (CIs) to determine associations between smoking status and the likelihood of nonadherence. All models were adjusted for race/ethnicity, age, insurance, primary care specialty, number of comorbidities, and sex. Smoking history was obtained from all participants in January 2020. Current smokers accounted for 4.8%, while 22.7% were former smokers, and 72.5% were never smokers. Current smokers (compared to never smokers) were 63% more likely to be mammogram nonadherent (PR: 1.63, 95% CI: 1.31 to 2.02), 26% more likely to be Pap smear nonadherent (PR: 1.26, 95% CI: 1.04 to 1.53), and 39% more likely to be colonoscopy nonadherent (PR: 1.39, 95% CI: 1.16 to 1.66). Current smokers and former Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smokers had on average 2.9 comorbidities while never smokers had on average 2.1 comorbidities. Our findings showed that current smokers experienced significantly lower rates of cancer screening compared to never smokers. Further research is needed to investigate and identify best practices for increasing cancer screening uptake in this population. Abstract : At present, information is needed about the relationships between smoking and cancer screening within primary care practices. This study aims to explore cancer screening behaviors of smokers and non-smokers among patients who regularly attended large primary care practices. Smoking appeared to be a barrier to the delivery of recommended cancer screening in these patients since smokers — even though they regularly saw their primary care physicians — — were significantly less likely to have adhered to cancer screening recommendations for each of the cancers studied. This observation leads us to that special attention to adherence is needed for primary care patients who continue to smoke.