Primary Care Providers Play Important Role in Cancer Screening Uptake

Primary care providers (PCPs) play a critical role in cancer diagnosis, according to a new study from researchers at the University of Michigan Rogel Cancer Center. The findings showed that the relationship between patients and their PCPs influenced the timeliness of cancer screening, even among populations that have historically low screening rates.

PCPs May Encourage Preventative Care

The study was published in eLife and found that patients’ relationships with their PCPs was associated with being up to date on preventative cancer screenings. The investigators surveyed a multiethnic sample of women in southeast Michigan regarding their uptake of cervical cancer and colorectal cancer screenings.

“Women 50–65 years of age have the lowest cervical and colorectal cancer screening rates among ages recommended for screening,” wrote the study authors. “The primary aim of this work is to determine how cancer risk perceptions and provider communication behaviors, in addition to known demographic factors, influence the uptake of both cervical and colorectal cancer screening or a single screen among women in southeast Michigan.”

In total, 394 patients aged 50 to 65 years responded to the questionnaire. More than half (54%) of respondents were up to date on both screenings. Twenty-one percent were up to date on only cervical cancer screening, and 12% were up to date on colorectal cancer screening only.

Communication Improves Screening Uptake

The results showed that the relationship between patients and their PCPs significantly impacted screening incidence.

“Of the 14 risk perception and communication behavior questions, only ‘Did your PCP involve you in the decisions about your health care as much as you wanted?’ was significantly associated with women having both screens compared to only cervical cancer screening,” the authors noted.

When the researchers compared women who completed both screenings compared to those who had only one screening, they found that communication about health decisions with a PCP was still associated with being up to date on both screenings compared to one.

“We showed for the first time that the relationship between the PCP and the woman was the important distinguishing factor in dual cancer screening,” said Diane M. Harper, MD, MPH, PCP at Michigan Medicine and professor of at the University of Michigan Medical School, via press release. “This creates a hypothesis that comprehensive cancer screening may best be accomplished through a PCP-patient relationship and not through targeted single cancer site screenings.”

Furthermore, multivariate assessment found that age, Middle Eastern and North African ethnicity, and Black race were also associated with completed cancer screenings.

The authors concluded, “Optimizing PCP-patient decision-making in health care may increase opportunities for both cervical cancer and CRC screening either in the office or by self-sampling. Understanding the effects of age and the different interventional strategies needed for Middle Eastern and North African women compared to Black women will inform future intervention trials aimed to increase both cancer screenings.”