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  • Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study

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Public health
Research
Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study
  1. Karen E Lasser1,2,
  2. Theresa W Kim1,3,
  3. Daniel P Alford1,3,
  4. Howard Cabral4,
  5. Richard Saitz1,3,5,
  6. Jeffrey H Samet1,2,3
  1. 1Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
  3. 3Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
  4. 4Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
  5. 5Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Karen E Lasser; karen.lasser{at}bmc.org

Abstract

Objective To compare cancer screening and flu vaccination among persons with and without unhealthy substance use.

Design The authors analysed data from 4804 women eligible for mammograms, 4414 eligible for Papanicolou (Pap) smears, 7008 persons eligible for colorectal cancer (CRC) screening and 7017 persons eligible for flu vaccination. All patients were screened for unhealthy substance use. The main outcome was completion of cancer screening and flu vaccination.

Results Among the 9995 patients eligible for one or more of the preventive services of interest, 10% screened positive for unhealthy substance use. Compared with women without unhealthy substance use, women with unhealthy substance use received mammograms less frequently (75.4% vs 83.8%; p<0.0001), but Pap smears no less frequently (77.9% vs 78.1%). Persons with unhealthy substance use received CRC screening no less frequently (61.7% vs 63.4%), yet received flu vaccination less frequently (44.7% vs 50.4%; p=0.01). In multivariable analyses, women with unhealthy substance use were less likely to receive mammograms (adjusted odds ratio 0.68; 95% CI 0.52 to 0.89), and persons with unhealthy substance use were less likely to receive flu vaccination (adjusted odds ratio 0.81; 95% CI 0.67 to 0.97).

Conclusions Unhealthy substance use is a risk factor for not receiving all appropriate preventive health services.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2010-000046

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    Footnotes

    • To cite: Lasser KE, Kim TW, Alford DP, et al. Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study. BMJ Open 2011;1:e000046. doi:10.1136/bmjopen-2010-000046

    • Preliminary findings were presented at the Society of General Internal Medicine conference, 28 April to 1 May 2010, Minneapolis, Minnesota, and the Quality of Behavioral Healthcare Conference, 14 April 2010, Clearwater, Florida.

    • Funding This study was supported by Mentored Research Scholar Grant MRSGT-05-007-01-CPPB from the American Cancer Society (KEL), the Substance Abuse and Mental Health Services Administration (1UTI018311) and the Massachusetts Department of Public Health Bureau of Substance Abuse Services.

    • Competing interests None.

    • Contributors KEL conceived and planned the work that led to the article. She wrote the paper and approved the final version. TWK played an important role in interpreting the results, made substantive suggestions for revision and approved the final version. DPA played an important role in interpreting the results, made substantive suggestions for revision and approved the final version. HC played an important role in interpreting the results, made substantive suggestions for revision and approved the final version. RS played an important role in interpreting the results, made substantive suggestions for revision and approved the final version. JHS played an important role in interpreting the results, made substantive suggestions for revision and approved the final version.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Statistical code is available from the corresponding author at Karen.lasser@bmc.org. Consent was not obtained but the presented data are anonymised and risk of identification is low.