Cancer Education Among Primary Care Physicians in an Underserved Community; Cancer Screening and Prevention Practices of Inner-City Physicians

Abstract

Am J Prev Med 2000;19:53–58, 59–62 These reports from a New York epidemiology group explored knowledge about and practice of cancer prevention strategies among primary care physicians from north Manhattan, Harlem, and south Bronx. Inner-city physicians were less knowledgeable about cancer prevention and screening guidelines than surveyed national and local peers, although 98% claimed to usually recommend Pap smear screening. Barriers to provision of cancer prevention services included lack of time and lack of reimbursement; only 11% cited cultural differences as a major barrier. An intervention trial explored the utility of academic visits to clinicians' offices, which were defined as educational sessions conducted by the survey team to improve knowledge about the value of various screening and health maintenance measures, including Pap smears. The cancer prevention teams did not find significant improvement in clinicians' scores that were designed by the researchers to measure cognitive knowledge about screening and health maintenance when tested on the subject, though the authors speculated that the lack of improvement was due to a pre-test study that may have artificially raised scores. Comment: Indigent urban women, often from minority groups, suffer disproportionately from cervical cancer. Reducing this burden requires educated clinicians who will recommend screening. Although inner-city clinicians appear to know less than local and national peers about cancer prevention in general, further education did not improve screening, and they do appear to be highly aware of Pap smear screening guidelines. These studies evaluated self-reported not actual practice, which may be limited by time and financial barriers. (LSM)