Screening for cancer by residents in an internal medicine program

A study was conducted by the authors to explore screening for cancer by internal medicine residents in a primary care clinic. The charts of 151 patients over 40 years of age followed by residents in the outpatient clinic of an innercity hospital were reviewed for documentation of screening on initial evaluation or on follow-up within 12 months of the initial visit. The residents were unaware of the chart review, and cancer screening had received no special emphasis in their training program. Screening was more frequently performed on male patients than female patients: smoking history (61 percent of males, 34 percent of females); alcohol history (64 percent of males, 26 percent of females); occupational history (48 percent of males, 15 percent of females); and testing for hidden blood in stools (73 percent of males, 41 percent of females). Breast examination and Pap smears were done on 33 percent and 29 percent of the women patients, respectively, with women residents performing them slightly more frequently than male residents. This low rate of cancer risk screening suggests the need for intensive education of residents on the potential for cancer prevention through early detection.