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Prevention practices and family history of cancer of medical students in the United States
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ABSTRACTS (ACE)
protein test. Self-reported complications included the presence of diabetic eye disease requiring laser therapy, myocardial infarction, stroke, diabetes-related renal failure, or amputation. Logistic regression analysis was used to examine the association between high risk and receipt of screening test. Models were adjusted for disease duration and diabetes complications. RESULTS: In unadjusted analysis, high risk was associated with receipt of fasting lipid test (OR Z 1.785, p Z .038); foot examination (OR Z 1.956, p Z .012), urine test for protein (OR Z 1.998, p Z .017), and receipt of all screening tests (OR Z 2.07, p Z .005). In adjusted analysis, high risk remained a significant predictor of urine test for protein (OR Z 2.0, p Z .022), foot exam (OR Z 2.0, p Z .01), and receipt of all screening tests (OR Z 1.9, p Z .015). CONCLUSION: It appears as though individuals at high risk are more likely to get recommended screening tests.
P56 PREVENTION PRACTICES AND FAMILY HISTORY OF CANCER OF MEDICAL STUDENTS IN THE UNITED STATES S Coughlin, FE Carrera, J Saraiya, Division of Cancer Prevention and Control, CDC, and Emory University School of Medicine, Atlanta, GA PURPOSE: Few studies have examined whether physicians’ own family history of cancer influences what they do for their patients or for themselves. To clarify the role of family history in medical students’ cancer prevention habits and in patient counseling and screening for cancer, we examined data from the Healthy Doc Z Healthy Patient study. METHODS: To determine basic health practices and status, we surveyed medical students (n Z 2,316 individuals responding to > 1 survey) in the Class of 2003 at freshman orientation, entrance to wards, and senior year in a nationally representative sample of 16 medical schools (response rate Z 80.3%). Using a checklist in the self-administered questionnaire, the medical students were asked to indicate whether they had a number of health conditions (including colorectal cancer, breast cancer, lung cancer, skin cancer, prostate cancer, or other cancers) now or in the past, or whether a parent, sibling or grandparent had any of the health conditions. They were also asked how relevant they think several prevention activities related to counseling or early detection of cancer will be in their intended practice. The main outcome measures were relevance of prevention counseling to medical students’ intended clinical practice (available at all three survey points), and seniors’ frequency of counseling typical general medicine patients about cancer prevention. Family history of cancer was measured in relation to each outcome of interest. SUDAAN and logistic regression were used in the analysis, treating each school as a cluster. RESULTS: Family history of cancer was generally not significantly related to current counseling or perceived future counseling relevance, though reported family history of skin cancer did increase the odds that a student thought that recommending a clinical skin exam was highly relevant to their intended practice (adjusted OR Z 1.56, 95% CI: 1.01, 2.43).
AEP Vol. 15, No. 8 September 2005: 630–665
DISCUSSION: These results suggest that physician family history may influence their patient skin cancer early detection practices but not other preventive practices.
P57 COMPLEMENTARY AND ALTERNATIVE MEDICINE USE AMONG MID-LIFE WOMEN KM Brett, Office of Analysis and Epidemiology, National Center for Health Statistics/CDC, Hyattsville, MD PURPOSE: Complementary and alternative medicine (CAM) has become widely used, with approximately 22% of all adults having used CAM in 2002. Many women are investigating alternatives to hormone therapy for menopausal symptoms, in part due to the recent results of the Women’s Health Initiative. Physicians should ascertain CAM use in their patients to avoid possible interactions with prescribed drug. This study analyzes CAM use among menopausal women and CAM used specifically for menopausal symptoms. METHODS: Data were obtained from the 2002 National Health Interview Survey (NHIS). The sample was limited to women 45– 57 years of age for whom menopausal symptom data were obtained (n Z 3663). CAM use was analyzed by SUDAAN to account for the complex sampling design of the NHIS and weighted to obtain nationally representative estimates. RESULTS: More than 43% of women 45–57 used CAM in the previous year. Use increased with education, from 28% among women without a high school degree to 63% among women with a master’s degree or higher. After controlling for age and race/ ethnicity, women who reported menopausal symptoms were almost twice as likely to use CAM as those without symptoms (prevalence odds ratio Z 1.8, 95% confidence interval (CI 95%) Z 1.5,2.1). Forty six percent of women using CAM had informed a traditional health practitioner of this, which was not significantly associated with demographic or menopause characteristics. Only 3.3% of women 45–57 used CAM specifically for menopause (CI 95% Z 2.7%–4.0%), with natural herbs the modality mentioned by 2.8%. Education was positively associated with CAM used specifically for menopausal symptoms. CONCLUSION: CAM use among mid-life women is higher than use among all U.S. adults. Women experiencing menopausal symptoms are almost twice as likely to use CAM as other women at the same age, especially among more highly educated women. The use of CAM, however, is generally not related specifically to menopause. More physicians need to ask their patients about CAM use to obtain complete medical histories.
INFECTIOUS DISEASE P58 THE PATTERNS OF HEPATITIS A EPIDEMIOLOGY IN MANITOBA 1992–2003: IMPLICATIONS FOR VACCINATION STRATEGIES HX Wu1, G Smart2, J Wu1, A Giulivi1, Z Hong1, M Dawood2, 1 BSSHCI Division, Public Health Agency of Canada, Ottawa, Canada, 2Cadham Provincial Laboratory, Winnipeg, MB R3E 3J7, Canada OBJECTIVES: The objective of this study is to examine annual trends in the incidence of hepatitis A virus (HAV) infection, and
ABSTRACTS (ACE)
protein test. Self-reported complications included the presence of diabetic eye disease requiring laser therapy, myocardial infarction, stroke, diabetes-related renal failure, or amputation. Logistic regression analysis was used to examine the association between high risk and receipt of screening test. Models were adjusted for disease duration and diabetes complications. RESULTS: In unadjusted analysis, high risk was associated with receipt of fasting lipid test (OR Z 1.785, p Z .038); foot examination (OR Z 1.956, p Z .012), urine test for protein (OR Z 1.998, p Z .017), and receipt of all screening tests (OR Z 2.07, p Z .005). In adjusted analysis, high risk remained a significant predictor of urine test for protein (OR Z 2.0, p Z .022), foot exam (OR Z 2.0, p Z .01), and receipt of all screening tests (OR Z 1.9, p Z .015). CONCLUSION: It appears as though individuals at high risk are more likely to get recommended screening tests.
P56 PREVENTION PRACTICES AND FAMILY HISTORY OF CANCER OF MEDICAL STUDENTS IN THE UNITED STATES S Coughlin, FE Carrera, J Saraiya, Division of Cancer Prevention and Control, CDC, and Emory University School of Medicine, Atlanta, GA PURPOSE: Few studies have examined whether physicians’ own family history of cancer influences what they do for their patients or for themselves. To clarify the role of family history in medical students’ cancer prevention habits and in patient counseling and screening for cancer, we examined data from the Healthy Doc Z Healthy Patient study. METHODS: To determine basic health practices and status, we surveyed medical students (n Z 2,316 individuals responding to > 1 survey) in the Class of 2003 at freshman orientation, entrance to wards, and senior year in a nationally representative sample of 16 medical schools (response rate Z 80.3%). Using a checklist in the self-administered questionnaire, the medical students were asked to indicate whether they had a number of health conditions (including colorectal cancer, breast cancer, lung cancer, skin cancer, prostate cancer, or other cancers) now or in the past, or whether a parent, sibling or grandparent had any of the health conditions. They were also asked how relevant they think several prevention activities related to counseling or early detection of cancer will be in their intended practice. The main outcome measures were relevance of prevention counseling to medical students’ intended clinical practice (available at all three survey points), and seniors’ frequency of counseling typical general medicine patients about cancer prevention. Family history of cancer was measured in relation to each outcome of interest. SUDAAN and logistic regression were used in the analysis, treating each school as a cluster. RESULTS: Family history of cancer was generally not significantly related to current counseling or perceived future counseling relevance, though reported family history of skin cancer did increase the odds that a student thought that recommending a clinical skin exam was highly relevant to their intended practice (adjusted OR Z 1.56, 95% CI: 1.01, 2.43).
AEP Vol. 15, No. 8 September 2005: 630–665
DISCUSSION: These results suggest that physician family history may influence their patient skin cancer early detection practices but not other preventive practices.
P57 COMPLEMENTARY AND ALTERNATIVE MEDICINE USE AMONG MID-LIFE WOMEN KM Brett, Office of Analysis and Epidemiology, National Center for Health Statistics/CDC, Hyattsville, MD PURPOSE: Complementary and alternative medicine (CAM) has become widely used, with approximately 22% of all adults having used CAM in 2002. Many women are investigating alternatives to hormone therapy for menopausal symptoms, in part due to the recent results of the Women’s Health Initiative. Physicians should ascertain CAM use in their patients to avoid possible interactions with prescribed drug. This study analyzes CAM use among menopausal women and CAM used specifically for menopausal symptoms. METHODS: Data were obtained from the 2002 National Health Interview Survey (NHIS). The sample was limited to women 45– 57 years of age for whom menopausal symptom data were obtained (n Z 3663). CAM use was analyzed by SUDAAN to account for the complex sampling design of the NHIS and weighted to obtain nationally representative estimates. RESULTS: More than 43% of women 45–57 used CAM in the previous year. Use increased with education, from 28% among women without a high school degree to 63% among women with a master’s degree or higher. After controlling for age and race/ ethnicity, women who reported menopausal symptoms were almost twice as likely to use CAM as those without symptoms (prevalence odds ratio Z 1.8, 95% confidence interval (CI 95%) Z 1.5,2.1). Forty six percent of women using CAM had informed a traditional health practitioner of this, which was not significantly associated with demographic or menopause characteristics. Only 3.3% of women 45–57 used CAM specifically for menopause (CI 95% Z 2.7%–4.0%), with natural herbs the modality mentioned by 2.8%. Education was positively associated with CAM used specifically for menopausal symptoms. CONCLUSION: CAM use among mid-life women is higher than use among all U.S. adults. Women experiencing menopausal symptoms are almost twice as likely to use CAM as other women at the same age, especially among more highly educated women. The use of CAM, however, is generally not related specifically to menopause. More physicians need to ask their patients about CAM use to obtain complete medical histories.
INFECTIOUS DISEASE P58 THE PATTERNS OF HEPATITIS A EPIDEMIOLOGY IN MANITOBA 1992–2003: IMPLICATIONS FOR VACCINATION STRATEGIES HX Wu1, G Smart2, J Wu1, A Giulivi1, Z Hong1, M Dawood2, 1 BSSHCI Division, Public Health Agency of Canada, Ottawa, Canada, 2Cadham Provincial Laboratory, Winnipeg, MB R3E 3J7, Canada OBJECTIVES: The objective of this study is to examine annual trends in the incidence of hepatitis A virus (HAV) infection, and