Background: Prevention of cancer in primary care has focused on modifying behaviours associated with increased risk of cancer (primary prevention) or increasing participation in national cancer screening programs (secondary prevention). On the basis of metaanalyses of large prevention trials, a new paradigm in primary prevention – chemoprevention – is beginning to enter the realms of primary care for specific populations.
Objectives: In this article, we discuss two examples of cancer chemoprevention relevant to general practice: low-dose aspirin for the prevention of colorectal cancer in people aged 50–70 years, and selective oestrogen receptor modulators (SERMs) for women at increased risk of breast cancer. We present new expected frequency trees that show the absolute benefits and harms of taking these medications in specific populations.
Discussion: These expected frequency trees can serve as risk-communication aids to support shared decision making and the implementation of new chemoprevention guidelines in general practice.
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http://dx.doi.org/10.31128/AJGP-07-18-4644 | DOI Listing |
J Prim Care Community Health
January 2025
University of California, Davis, Division of Hospital Medicine, Sacramento, CA, USA.
Introduction: Nadezhda Clinic is a free student-run health clinic that provides culturally sensitive primary care services to the underserved Russian-speaking population of the greater Sacramento area. At the onset of the COVID-19 pandemic, the clinic suspended in-person services and solely offered telemedicine visits. Most patients were hesitant to utilize telemedicine due to poor technological literacy, privacy concerns, and a preference for in-person care.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Clinical Product Development, Waymark, San Francisco, California.
Importance: Rising prescription medication costs under Medicaid have led to increased procedural prescription denials by health plans. The effect of unresolved denials on chronic condition exacerbation and subsequent acute care utilization remains unclear.
Objective: To examine whether procedural prescription denials are associated with increased net spending through downstream acute care utilization among Medicaid patients not obtaining prescribed medication following a denial.
JAMA Netw Open
January 2025
S-SPIRE Center, Department of Surgery, Stanford University School of Medicine, Stanford, California.
Importance: Transportation insecurity and lack of social support are 2 understudied social determinants of health that contribute to excess morbidity, mortality, and acute health care utilization. However, whether and how these social determinants of health are associated with cancer screening has not been determined and has implications for preventive care.
Objective: To determine whether transportation insecurity or social support are associated with screening adherence for colorectal, breast, and cervical cancer.
J Prim Care Community Health
January 2025
Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
Aim: To investigate the detection and initial management of first psychotic episodes, as well as established schizophrenia, within the primary care of the Andalusian Health System.
Background: Delay in detecting and treating psychosis is associated with slower recovery, higher relapse risk, and poorer long-term outcomes. Often, psychotic episodes go unnoticed for years before a diagnosis is established.
JAMA
January 2025
Departments of Family Medicine and Community Health and Psychiatry and Behavioral Sciences, Duke University Hospital, Durham, North Carolina.
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