RT Journal Article SR Electronic T1 Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e000046 DO 10.1136/bmjopen-2010-000046 VO 1 IS 1 A1 Karen E Lasser A1 Theresa W Kim A1 Daniel P Alford A1 Howard Cabral A1 Richard Saitz A1 Jeffrey H Samet YR 2011 UL http://bmjopen.bmj.com/content/1/1/e000046.abstract AB 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.