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基层医疗环境中的皮肤癌筛查与预防:1997年国家门诊医疗调查

Skin cancer screening and prevention in the primary care setting: national ambulatory medical care survey 1997.

作者信息

Oliveria S A, Christos P J, Marghoob A A, Halpern A C

机构信息

Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

出版信息

J Gen Intern Med. 2001 May;16(5):297-301. doi: 10.1046/j.1525-1497.2001.00526.x.

Abstract

OBJECTIVE

To describe skin cancer prevention and screening activities in the primary care setting and to compare these findings to other cancer screening and prevention activities.

DESIGN

Descriptive study.

SETTING/PATIENTS: National Ambulatory Medical Care Survey 1997 data on office-based physician visits to family practitioners and internists.

MEASUREMENTS AND MAIN RESULTS

Data were obtained on 784 primary care visits to 109 family practitioners and 61 internists. We observed that the frequency of skin cancer prevention and screening activities in the primary care setting was much lower than other cancer screening and prevention activities. Skin examination was reported at only 15.8% of all visits (17.4% for family practitioners vs 13.6% for internists, P >.1). For other cancer screening, the frequencies were as follows: breast examination, 30.3%; Papanicolaou test, 25.3%; pelvic examination, 27.6%; and rectal examination, 17.9%. Skin cancer prevention in the form of education and counseling was reported at 2.3% of these visits (2.9% for family practitioners vs 1.5% for internists, P >.1), while education on breast self-examination, diet and nutrition, tobacco use, and exercise was 13.0%, 25.3%, 5.7%, and 17.9%, respectively.

CONCLUSIONS

The results of this study indicate that the proportion of primary care visits in which skin cancer screening and prevention occurs is low. Strategies to increase skin cancer prevention and screening by family practitioners and internists need to be considered.

摘要

目的

描述基层医疗环境中的皮肤癌预防和筛查活动,并将这些结果与其他癌症筛查和预防活动进行比较。

设计

描述性研究。

地点/患者:1997年全国门诊医疗护理调查中关于家庭医生和内科医生门诊就诊的数据。

测量和主要结果

获取了109名家庭医生和61名内科医生的784次基层医疗就诊数据。我们观察到,基层医疗环境中皮肤癌预防和筛查活动的频率远低于其他癌症筛查和预防活动。在所有就诊中,仅15.8%的就诊报告了皮肤检查(家庭医生为17.4%,内科医生为13.6%,P>.1)。对于其他癌症筛查,频率如下:乳房检查为30.3%;巴氏试验为25.3%;盆腔检查为27.6%;直肠检查为17.9%。以教育和咨询形式进行的皮肤癌预防在这些就诊中报告率为2.3%(家庭医生为2.9%,内科医生为1.5%,P>.1),而乳房自我检查、饮食与营养、烟草使用和运动方面的教育分别为13.0%、25.3%、5.7%和17.9%。

结论

本研究结果表明,进行皮肤癌筛查和预防的基层医疗就诊比例较低。需要考虑制定策略以增加家庭医生和内科医生对皮肤癌的预防和筛查。

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