Skip to main content
Top
Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians

Authors: Deanna Kepka, Alexandria Smith, Christopher Zeruto, K Robin Yabroff

Published in: BMC Cancer | Issue 1/2014

Login to get access

Abstract

Background

Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians’ ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations.

Methods

Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n = 26,716).

Results

In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p < 0.0001 for provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p < 0.01 for provider type).

Conclusions

Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform.
Literature
4.
go back to reference Yarnall KS, Pollak KI, Ostbye T, Krause KM, Michener JL: Primary care: is there enough time for prevention?. Am J Public Health. 2003, 93 (4): 635-641. 10.2105/AJPH.93.4.635.CrossRefPubMedPubMedCentral Yarnall KS, Pollak KI, Ostbye T, Krause KM, Michener JL: Primary care: is there enough time for prevention?. Am J Public Health. 2003, 93 (4): 635-641. 10.2105/AJPH.93.4.635.CrossRefPubMedPubMedCentral
6.
go back to reference Wagner EH: Chronic disease management: what will it take to improve care for chronic illness?. Eff Clin Pract. 1998, 1 (1): 2-4.PubMed Wagner EH: Chronic disease management: what will it take to improve care for chronic illness?. Eff Clin Pract. 1998, 1 (1): 2-4.PubMed
9.
go back to reference Division of Health Interview Statistics: National health interview survey (NHIS) public Use data release: NHIS survey description. 2011, Hyattsville, Maryland: National Center for Health Statistics, ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2010/srvydesc.pdf Division of Health Interview Statistics: National health interview survey (NHIS) public Use data release: NHIS survey description. 2011, Hyattsville, Maryland: National Center for Health Statistics, ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2010/srvydesc.pdf
10.
11.
go back to reference DiMatteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz RL, McGlynn EA, Kaplan S, Rogers WH: Physicians’ characteristics influence patients’ adherence to medical treatment: results from the medical outcomes study. Health Psychol. 1993, 12 (2): 93-102.CrossRefPubMed DiMatteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz RL, McGlynn EA, Kaplan S, Rogers WH: Physicians’ characteristics influence patients’ adherence to medical treatment: results from the medical outcomes study. Health Psychol. 1993, 12 (2): 93-102.CrossRefPubMed
12.
go back to reference Wells KB, Lewis CE, Leake B, Schleiter MK, Brook RH: The practices of general and subspecialty internists in counseling about smoking and exercise. Am J Public Health. 1986, 76 (8): 1009-1013. 10.2105/AJPH.76.8.1009.CrossRefPubMedPubMedCentral Wells KB, Lewis CE, Leake B, Schleiter MK, Brook RH: The practices of general and subspecialty internists in counseling about smoking and exercise. Am J Public Health. 1986, 76 (8): 1009-1013. 10.2105/AJPH.76.8.1009.CrossRefPubMedPubMedCentral
13.
go back to reference Phillips SJ: 26th Annual legislative update: progress for APRN authority to practice. Nurse Pract. 2014, 39 (1): 29-52. 10.1097/01.NPR.0000440642.09390.fa.CrossRefPubMed Phillips SJ: 26th Annual legislative update: progress for APRN authority to practice. Nurse Pract. 2014, 39 (1): 29-52. 10.1097/01.NPR.0000440642.09390.fa.CrossRefPubMed
20.
go back to reference Swan J, Breen N, Graubard BI, McNeel TS, Blackman D, Tangka FK, Ballard-Barbash R: Data and trends in cancer screening in the United States: results from the 2005 national health interview survey. Cancer. 2010, 116 (20): 4872-4881. 10.1002/cncr.25215.CrossRefPubMedPubMedCentral Swan J, Breen N, Graubard BI, McNeel TS, Blackman D, Tangka FK, Ballard-Barbash R: Data and trends in cancer screening in the United States: results from the 2005 national health interview survey. Cancer. 2010, 116 (20): 4872-4881. 10.1002/cncr.25215.CrossRefPubMedPubMedCentral
21.
go back to reference Coleman K, Austin BT, Brach C, Wagner EH: Evidence on the chronic care model in the new millennium. Health Aff. 2009, 28 (1): 75-85. 10.1377/hlthaff.28.1.75.CrossRef Coleman K, Austin BT, Brach C, Wagner EH: Evidence on the chronic care model in the new millennium. Health Aff. 2009, 28 (1): 75-85. 10.1377/hlthaff.28.1.75.CrossRef
22.
go back to reference Wagner EH, Austin BT, Von Korff M: Organizing care for patients with chronic illness. Milbank Q. 1996, 74 (4): 511-544. 10.2307/3350391.CrossRefPubMed Wagner EH, Austin BT, Von Korff M: Organizing care for patients with chronic illness. Milbank Q. 1996, 74 (4): 511-544. 10.2307/3350391.CrossRefPubMed
23.
go back to reference Shi L, Starfield B, Kennedy B, Kawachi I: Income inequality, primary care, and health indicators. J Fam Pract. 1999, 48 (4): 275-284.PubMed Shi L, Starfield B, Kennedy B, Kawachi I: Income inequality, primary care, and health indicators. J Fam Pract. 1999, 48 (4): 275-284.PubMed
24.
go back to reference Macinko J, Starfield B, Shi L: Quantifying the health benefits of primary care physician supply in the United States. Int J Health Serv. 2007, 37 (1): 111-126. 10.2190/3431-G6T7-37M8-P224.CrossRefPubMed Macinko J, Starfield B, Shi L: Quantifying the health benefits of primary care physician supply in the United States. Int J Health Serv. 2007, 37 (1): 111-126. 10.2190/3431-G6T7-37M8-P224.CrossRefPubMed
25.
go back to reference Shi L, Starfield B, Politzer R, Regan J: Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res. 2002, 37 (3): 529-550. 10.1111/1475-6773.t01-1-00036.CrossRefPubMedPubMedCentral Shi L, Starfield B, Politzer R, Regan J: Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res. 2002, 37 (3): 529-550. 10.1111/1475-6773.t01-1-00036.CrossRefPubMedPubMedCentral
26.
go back to reference Murphy PA: Primary care for women. Health assessment, health promotion, and disease prevention services. J Nurse Midwifery. 1996, 41 (2): 83-91. 10.1016/0091-2182(96)00010-9.CrossRefPubMed Murphy PA: Primary care for women. Health assessment, health promotion, and disease prevention services. J Nurse Midwifery. 1996, 41 (2): 83-91. 10.1016/0091-2182(96)00010-9.CrossRefPubMed
27.
go back to reference Hopkins SC, Lenz ER, Pontes NM, Lin SX, Mundinger MO: Context of care or provider training: the impact on preventive screening practices. Prev Med. 2005, 40 (6): 718-724. 10.1016/j.ypmed.2004.09.013.CrossRefPubMed Hopkins SC, Lenz ER, Pontes NM, Lin SX, Mundinger MO: Context of care or provider training: the impact on preventive screening practices. Prev Med. 2005, 40 (6): 718-724. 10.1016/j.ypmed.2004.09.013.CrossRefPubMed
28.
go back to reference Oliveria SA, Altman JF, Christos PJ, Halpern AC: Use of nonphysician health care providers for skin cancer screening in the primary care setting. Prev Med. 2002, 34 (3): 374-379. 10.1006/pmed.2001.0995.CrossRefPubMed Oliveria SA, Altman JF, Christos PJ, Halpern AC: Use of nonphysician health care providers for skin cancer screening in the primary care setting. Prev Med. 2002, 34 (3): 374-379. 10.1006/pmed.2001.0995.CrossRefPubMed
29.
go back to reference Menees SB, Patel DA, Dalton V: Colorectal cancer screening practices among obstetrician/gynecologists and nurse practitioners. J Womens Health. 2009, 18 (8): 1233-1238. 10.1089/jwh.2008.1117.CrossRef Menees SB, Patel DA, Dalton V: Colorectal cancer screening practices among obstetrician/gynecologists and nurse practitioners. J Womens Health. 2009, 18 (8): 1233-1238. 10.1089/jwh.2008.1117.CrossRef
30.
go back to reference Mandelblatt J, Traxler M, Lakin P, Thomas L, Chauhan P, Matseoane S, Kanetsky P: A nurse practitioner intervention to increase breast and cervical cancer screening for poor, elderly black women. The Harlem study team. J Gen Intern Med. 1993, 8 (4): 173-178. 10.1007/BF02599260.CrossRefPubMed Mandelblatt J, Traxler M, Lakin P, Thomas L, Chauhan P, Matseoane S, Kanetsky P: A nurse practitioner intervention to increase breast and cervical cancer screening for poor, elderly black women. The Harlem study team. J Gen Intern Med. 1993, 8 (4): 173-178. 10.1007/BF02599260.CrossRefPubMed
31.
go back to reference Lin SX, Gebbie KM, Fullilove RE, Arons RR: Do nurse practitioners make a difference in provision of health counseling in hospital outpatient departments?. J Am Acad Nurse Pract. 2004, 16 (10): 462-466. 10.1111/j.1745-7599.2004.tb00425.x.CrossRefPubMed Lin SX, Gebbie KM, Fullilove RE, Arons RR: Do nurse practitioners make a difference in provision of health counseling in hospital outpatient departments?. J Am Acad Nurse Pract. 2004, 16 (10): 462-466. 10.1111/j.1745-7599.2004.tb00425.x.CrossRefPubMed
32.
go back to reference Moody NB, Smith PL, Glenn LL: Client characteristics and practice patterns of nurse practitioners and physicians. Nurse Pract. 1999, 24 (3): 94-96. 99–100, 102–103CrossRefPubMed Moody NB, Smith PL, Glenn LL: Client characteristics and practice patterns of nurse practitioners and physicians. Nurse Pract. 1999, 24 (3): 94-96. 99–100, 102–103CrossRefPubMed
33.
go back to reference Zahnd EG, Coates TJ, Richard RJ, Cummings SR: Counseling medical patients about cigarette smoking: a comparison of the impact of training on nurse practitioners and physicians. Nurse Pract. 1990, 15 (3): 10-13. 17–18CrossRefPubMed Zahnd EG, Coates TJ, Richard RJ, Cummings SR: Counseling medical patients about cigarette smoking: a comparison of the impact of training on nurse practitioners and physicians. Nurse Pract. 1990, 15 (3): 10-13. 17–18CrossRefPubMed
34.
go back to reference Price JH, Jordan TR, Dake JA: Perceptions and use of smoking cessation in nurse-midwives’ practice. J Midwifery Womens Health. 2006, 51 (3): 208-215. 10.1016/j.jmwh.2005.12.003.CrossRefPubMed Price JH, Jordan TR, Dake JA: Perceptions and use of smoking cessation in nurse-midwives’ practice. J Midwifery Womens Health. 2006, 51 (3): 208-215. 10.1016/j.jmwh.2005.12.003.CrossRefPubMed
35.
go back to reference Fasser CE, Mullen PD, Holcomb JD: Health beliefs and behaviors of physician assistants in Texas: implications for practice and education. Am J Prev Med. 1988, 4 (4): 208-215.PubMed Fasser CE, Mullen PD, Holcomb JD: Health beliefs and behaviors of physician assistants in Texas: implications for practice and education. Am J Prev Med. 1988, 4 (4): 208-215.PubMed
36.
go back to reference Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, Thun M: Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004, 54 (2): 78-93. 10.3322/canjclin.54.2.78.CrossRefPubMed Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, Thun M: Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004, 54 (2): 78-93. 10.3322/canjclin.54.2.78.CrossRefPubMed
38.
go back to reference Mays RM, Zimet GD: Recommending STI vaccination to parents of adolescents: the attitudes of nurse practitioners. Sex Transm Dis. 2004, 31 (7): 428-432. 10.1097/01.OLQ.0000130536.71812.E5.CrossRefPubMed Mays RM, Zimet GD: Recommending STI vaccination to parents of adolescents: the attitudes of nurse practitioners. Sex Transm Dis. 2004, 31 (7): 428-432. 10.1097/01.OLQ.0000130536.71812.E5.CrossRefPubMed
39.
go back to reference Shokar NK, Vernon SW, Carlson CA: Validity of self-reported colorectal cancer test use in different racial/ethnic groups. Fam Pract. 2011, 28 (6): 683-688. 10.1093/fampra/cmr026.CrossRefPubMedPubMedCentral Shokar NK, Vernon SW, Carlson CA: Validity of self-reported colorectal cancer test use in different racial/ethnic groups. Fam Pract. 2011, 28 (6): 683-688. 10.1093/fampra/cmr026.CrossRefPubMedPubMedCentral
40.
go back to reference Cronin KA, Miglioretti DL, Krapcho M, Yu B, Geller BM, Carney PA, Onega T, Feuer EJ, Breen N, Ballard-Barbash R: Bias associated with self-report of prior screening mammography. Cancer Epidemiol Biomarkers Prev. 2009, 18 (6): 1699-1705. 10.1158/1055-9965.EPI-09-0020.CrossRefPubMedPubMedCentral Cronin KA, Miglioretti DL, Krapcho M, Yu B, Geller BM, Carney PA, Onega T, Feuer EJ, Breen N, Ballard-Barbash R: Bias associated with self-report of prior screening mammography. Cancer Epidemiol Biomarkers Prev. 2009, 18 (6): 1699-1705. 10.1158/1055-9965.EPI-09-0020.CrossRefPubMedPubMedCentral
41.
go back to reference Champion VL, Menon U, McQuillen DH, Scott C: Validity of self-reported mammography in low-income African-American women. Am J Prev Med. 1998, 14 (2): 111-117. 10.1016/S0749-3797(97)00021-4.CrossRefPubMed Champion VL, Menon U, McQuillen DH, Scott C: Validity of self-reported mammography in low-income African-American women. Am J Prev Med. 1998, 14 (2): 111-117. 10.1016/S0749-3797(97)00021-4.CrossRefPubMed
42.
go back to reference Khoja S, McGregor SE, Hilsden RJ: Validation of self-reported history of colorectal cancer screening. Can Fam Physician. 2007, 53 (7): 1192-1197.PubMedPubMedCentral Khoja S, McGregor SE, Hilsden RJ: Validation of self-reported history of colorectal cancer screening. Can Fam Physician. 2007, 53 (7): 1192-1197.PubMedPubMedCentral
43.
go back to reference Caplan LS, McQueen DV, Qualters JR, Leff M, Garrett C, Calonge N: Validity of women’s self-reports of cancer screening test utilization in a managed care population. Cancer Epidemiol Biomarkers Prev. 2003, 12 (11 Pt 1): 1182-1187.PubMed Caplan LS, McQueen DV, Qualters JR, Leff M, Garrett C, Calonge N: Validity of women’s self-reports of cancer screening test utilization in a managed care population. Cancer Epidemiol Biomarkers Prev. 2003, 12 (11 Pt 1): 1182-1187.PubMed
Metadata
Title
Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians
Authors
Deanna Kepka
Alexandria Smith
Christopher Zeruto
K Robin Yabroff
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-233

Other articles of this Issue 1/2014

BMC Cancer 1/2014 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine