Having a Personal Healthcare Provider and Receipt of Adequate Cervical and Breast Cancer Screening

摘要

id="p1">Introduction: The purpose of this study was to assess the relationship between having a personal health care provider and adequate cervical and breast cancer screening behavior. id="p-2">Methods: Cross-sectional data were obtained from the 2004 Behavior Risk Factor Surveillance System. For cervical cancer, female respondents 18 years of age and older who did not have hysterectomy were included (n = 130,359); for breast cancer, female respondents 40 years of age or older were included (n = 129,929). Multiple logistic regression analyses were performed to determine the association between having a personal health care provider, specific demographics, and health insurance status with adequate cervical and breast cancer screening behavior. id="p-3">Results: Approximately 9% and 14% of the study population for the breast cancer and cervical cancer analyses, respectively, did not have a personal health care provider. Having at least one personal health care provider was significantly associated with adequate cervical cancer screening behavior (odds ratio, 2.37; 95% CI, 2.08–2.70) and breast cancer screening behavior (odds ratio, 2.86; 95% CI, 2.54–3.24) in multivariate analyses. Both multivariate analyses were adjusted for age, race/ethnicity, education, income, and health insurance. id="p-4">Conclusion: Having at least one personal health care provider was associated with adequate cervical and breast cancer screening behavior. Efforts to increase primary care access are a necessary part of the plan to increase preventive health services utilization. id="p-5">Despite spending $2 trillion per year (16% of gross domestic product) on health care, the US health care system faces challenges related to uninsured people (approximately 45 million), access to care, high cost, and racial/ethnic health care inequities.id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1 The US ranks lowest in patient satisfaction and health indicators among developed countries, highlighting a need for health care reform.id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2 Reports from other countries have shown that primary care physicians are one of the most important resources for providing high-quality health care.id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1 The Institutes of Medicine promulgates the importance of primary care in disease prevention, health promotion, and early detection of illnesses,id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3 which is evidenced by numerous studies.id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4 Primary care's impact has been especially highlighted in relation to preventive services utilization and cancer screening. However, it remains unclear whether health insurance status and having a primary care physician are independently related or interrelated to adequate cancer screening.id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5–7 id="p-6">Cervical and breast cancers cause a significant health burden among women, representing 34% of newly diagnosed cancers and 16% of all cancer deaths in United States.id="xref-ref-5-2" class="xref-bibr" href="#ref-5">5 Although screening rates for cervical and breast cancer have been increasing, they are still far from optimal.id="xref-ref-5-3" class="xref-bibr" href="#ref-5">5 Moreover, the 2003 National Health Care Disparities Report and the recent Surveillance Epidemiology and End Results Cancer Statistics Review found that minorities are less likely to receive cancer screening and have higher death rates.id="xref-ref-8-1" class="xref-bibr" href="#ref-8">8id="xref-ref-9-1" class="xref-bibr" href="#ref-9">,9 One predictor of adequate cervical cancer screening has been access to primary care physicians.id="xref-ref-10-1" class="xref-bibr" href="#ref-10">10id="xref-ref-11-1" class="xref-bibr" href="#ref-11">,11 id="p-7">The purpose of this study was to assess the association between having a personal health care provider (PHP) and adequate cervical and breast cancer screening after controlling for age, race/ethnicity, education, income, and health insurance status using data from the 2004 national Behavioral Risk Factor Surveillance System (BRFSS).