Department of Urology, New York University School of Medicine.
Department of Urology, Lineberger Comprehensive Cancer Center, University of North Carolina.
J Urol. 2021 Jun;205(6):1755-1761. doi: 10.1097/JU.0000000000001572. Epub 2021 Feb 2.
Tobacco use is a causative or exacerbating risk factor for benign and malignant urological disease. However, it is not well known how often urologists screen for tobacco use and provide tobacco cessation treatment at the population level. We sought to evaluate how often urologists see patients for tobacco-related diagnoses in the outpatient setting and how often these visits include tobacco use screening and treatment.
We used the National Ambulatory Medical Care Survey public use files for the years 2014-2016 to identify all outpatient urology visits with adults 18 years old or older. Clinic visit reasons were categorized according to diagnoses associated with the encounter: all urological diagnoses, a tobacco-related urological condition or a urological cancer. Our primary outcome was the percentage of visits during which tobacco screening was reported. Secondary outcomes included reported delivery of cessation counseling and provision of cessation pharmacotherapy.
We identified 4,625 unique urological outpatient encounters, representing a population-weighted estimate of 63.9 million visits over 3 years. Approximately a third of all urology visits were for a tobacco-related urological diagnosis and 15% were for urological cancers. An estimated 1.1 million visits over 3 years were with patients who identified as current tobacco users. Of all visits, 70% included tobacco screening. However, only 7% of visits with current smokers included counseling and only 3% of patients were prescribed medications. No differences in screening and treatment were observed between visit types.
Urologists regularly see patients for tobacco-related conditions and frequently, although not universally, screen patients for tobacco. However, urologists rarely offer counseling or cessation treatment. These findings may represent missed opportunities to decrease the morbidity associated with tobacco use.
烟草使用是良性和恶性泌尿系统疾病的致病或加重风险因素。然而，尚不清楚泌尿科医生在人群水平上筛查烟草使用情况并提供戒烟治疗的频率。我们试图评估泌尿科医生在门诊环境中治疗与烟草相关疾病的患者的频率，以及这些就诊中包含烟草使用筛查和治疗的频率。
我们使用 2014 年至 2016 年的国家门诊医疗保健调查公共使用文件，确定所有 18 岁及以上成年人的门诊泌尿科就诊。根据与就诊相关的诊断，将就诊原因分类：所有泌尿系统诊断、与烟草相关的泌尿系统疾病或泌尿系统癌症。我们的主要结果是报告烟草筛查的就诊比例。次要结果包括报告的戒烟咨询和提供戒烟药物治疗。
我们确定了 4625 个独特的泌尿科门诊就诊，代表 3 年内人群加权估计的 6390 万次就诊。所有泌尿科就诊中约有三分之一是与烟草相关的泌尿系统诊断，15%是泌尿系统癌症。估计 3 年内有 110 万次就诊是与当前烟草使用者进行的。在所有就诊中，70%包括烟草筛查。然而，只有 7%的吸烟者就诊包括咨询，只有 3%的患者被开出处方药。在就诊类型之间未观察到筛查和治疗的差异。
泌尿科医生经常为与烟草相关的疾病就诊，尽管不是普遍，但经常为患者筛查烟草。然而，泌尿科医生很少提供咨询或戒烟治疗。这些发现可能代表了减少与烟草使用相关的发病率的错失机会。
