Are Wellness Visits a Possible and Effective Cure for the Increasing Cancer Burden in Poland? Example of Women's Preventive Services in the U.S.

Abstract

Simple SummaryCancer remains one of the leading causes of death in Poland as well as in the United States. Modifiable risk factors, such as tobacco use, obesity, and low utilization of preventive cancer screenings, all contribute to greater cancer incidence and mortality in both countries. However, these risk factors have triggered some mitigating solutions in the U.S not seen in Poland, namely the implementation of standard annual wellness visits fully covered by health insurance. The aim of this study was to determine the level of impact that standardized, preventive wellness visits have had on uptake of cancer prevention measures, namely cancer screenings, among women in a largely rural region of the U.S. where cancer risk is often high. Based on the observation that wellness visits are associated with greater use of cancer screenings and other preventive health behaviors, findings from this study were used to support the inclusion of no-cost wellness visits into proposed strategies for systemic solutions to reduce cancer burden in Poland.Background: Cancer is one of the leading causes of death among Polish women in general, and first in women aged 25–64. Contributing to this cancer burden are modifiable behavioral risk factors, including low utilization of cancer screenings. Poland has an urgent need for new systemic solutions that will decrease cancer burden in the female Polish population. This study examined the United States’ implementation of preventive wellness visits as a viable solution for implementation in Poland. Methods: Health insurance claims data for nearly three million women in five states of the U.S. were examined to identify use of mammograms, colorectal cancer screening, and lung cancer screening. Three subgroups of the cohort were assessed for the probability of receipt of screening associated with type of healthcare visit history (women with wellness visits—W; with wellness visits and related preventive services and screenings—W+P; and control group—C). All multiple comparisons were significant (alpha = 0.05) at p < 0.0001, except comparison between subgroups (W vs. P+W) for lung cancer screening. Results: Breast and colorectal cancer screenings had substantially higher participation after W and W+P in comparison with C; moreover, a slight increase after W or P+W was seen for lung cancer as well. Conclusions: Results indicate that wellness visits are an effective tool for increasing cancer screening among women in the U.S. Introduction of a similar solution in Poland could potentially help produce higher screening rates, address cancer prevention needs (not only for secondary cancer prevention), and lower cancer burden.