OBJECTIVE: To assess whether @entity102 is a barrier to screening for @entity0 . DESIGN: Structured medical record review of a retrospectively defined cohort. SETTING: Two primary care clinics of one academic medical center. @entity1 : All eligible @entity1 at least 43 years of age seen during a 6-month period in each of the two study clinics (n = 1,764). MEASUREMENTS AND MAIN RESULTS: Study outcomes were whether @entity1 had been screened: for mammogram, every 2 years for ages 50-74; for clinical breast examinations (CBEs), every year for all ages; and for @entity975 smears, every 3 years for ages under 65. An index of comorbidity, adapted from Charlson (0 for no disease, maximum index of 8 among our @entity1 ), and specific @entity102 were the main independent variables. Demographics, clinic use, insurance, and clinical data were covariates. In the appropriate age groups for each test, 58% of @entity1 had a mammogram, 43% had a CBE, and 66% had a @entity975 smear. As comorbidity increased, screening rates decreased (p < .05 for linear trend). After adjustment, each unit increase in the comorbidity index corresponded to a 17% decrease in the likelihood of mammography (p = .005), 13% decrease in CBE (p = .006), and 20% decrease in @entity975 smears (p = .002). The rate of mammography in @entity1 with @entity5749 was only two fifths of that in @entity1 without. CONCLUSIONS: Among @entity1 who sought outpatient care, screening rates decreased as comorbidity increased. Whether clinicians and @entity1 are making appropriate decisions about screening is not known.

@entity102 as a barrier to XXXX screening.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'PATIENTS'] @entity975 :: ('5068', 'Gene') :: ['Pap'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast and cervical cancer'] @entity5749 :: ('MESH:D060050', 'Disease') :: ['stable angina'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic disease', 'chronic diseases']
@entity0 :: (MESH:D001943,Disease) :: ['breast and cervical cancer']
