Determinants of XXXX screening and treatment patterns. Insights for decision-makers.

@entity1 @entity165
BACKGROUND: Adult @entity165 screening and treatment policies by the National @entity165 Education Program recommend that physicians screen all adults aged > 20 [corrected]. On the other hand, the American College of Physicians recommends that healthy young adult @entity1 aged > 35 and premenopausal @entity1 aged > 45 not be screened due to concerns about the cost of and health risks associated with overuse of pharmacologic therapy in lieu of lifestyle modification. OBJECTIVES: The objectives of this study were to determine the type of treatment (lifestyle vs. pharmacologic) that physicians actually prescribe for individuals screened for elevated @entity165 . METHODS: Self-report data were derived from the 1989-1990 cross-sectional survey of the Stanford Five-City Project on 1,883 Latino and Anglo @entity1 and @entity1 aged 20 to 74 years of age. A four-stage sequential design was conducted using multiple stepwise regression analyses with a significance cutpoint of P < .01. RESULTS: Young adult @entity1 and @entity1 were significantly less likely to report ever having been screened (OR 1.02; 95% CI 1.07-1.09). Individuals of low socioeconomic status (SES) were also significantly less likely to report ever being screened (OR, 1.12; CI, 1.08-1.16), as were Latino @entity1 and @entity1 , regardless of age (OR 1.57; CI, 1.14-2.18). There were no significant differences in the pattern of physician care utilization among low SES or Latino individuals during the previous 12-month period. Among those under physician care to lower @entity165 , young adults were more likely to be prescribed lifestyle modification (OR, 0.95; CI, 0.92-0.98). CONCLUSIONS: Our results suggest that although young adults are less likely to be screened, if screened they are more likely to be prescribed lifestyle modification than pharmacologic treatment for elevated @entity165 . The lower prevalence of screening among low SES and Latino individuals suggests the need for policy discussions to reduce these disparities.
