Promoting cancer prevention activities by primary care physicians. Results of a randomized, controlled trial

JAMA. 1991 Jul;266(4):538-44.


Background: Previous interventions to promote performance of cancer prevention activities have largely targeted physicians in university-based practices.

Methods: We randomly assigned 40 primary care physicians in community-based practices to either (1) Cancer Prevention Reminders, computer-generated lists of overdue screening tests, and smoking and dietary assessment and counseling, supplemented by cancer education materials; or (2) controls. For each physician, we reviewed a random sample of 60 medical records for data about screening test, assessment, and counseling performance during 12-month preintervention and intervention periods. We calculated performance scores as percentage compliance with American Cancer Society and/or National Cancer Institute recommendations. Multiple regression analyses provided estimates of incremental differences in performance scores between intervention and control groups.

Results: Controlling for preintervention performance levels, significant incremental differences in performance scores between intervention and control groups (P less than .05) were achieved for nine maneuvers: stool occult-blood test, +14.5; rectal examination, +10.5; pelvic examination, +11.8; Papanicolaou's smear, +30.7; breast examination, +8.7; smoking assessment, +10.2; smoking counseling, +17.3; dietary assessment, +12.3; and dietary counseling, +13.9. Increments for sigmoidoscopy and mammography were not significant.

Conclusion: Computerized reminders can significantly increase physicians' performance of cancer prevention activities in community-based practices.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Health Promotion* / methods
  • Humans
  • Middle Aged
  • Neoplasms / prevention & control*
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Patient Compliance
  • Patient Education as Topic / methods
  • Physicians, Family*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Regression Analysis