Women who screen positive for unhealthy substance use receive mammograms less frequently than women who screen negative, a new study finds. In addition, both men and women who screen positive for unhealthy substance use are less likely to receive flu shots than patients not engaging in unhealthy substance use.

Researchers from Boston Medical Center and Boston University School of Medicine studied medical records of almost 10,000 patients who were eligible for preventive health services such as mammograms, Pap smears, flu vaccination or colon cancer screening. They defined unhealthy substance use as engaging in at least one of the following behaviors during the previous three months:

•    Having more than four alcoholic drinks in a day (for men under 65) or more than three drinks for women and for men 65 and older;
•    Using narcotic pain medicines, sedatives or Ritalin/amphetamines without a doctor’s prescription or in greater amounts than prescribed; or
•    Using marijuana, cocaine, heroin or other illegal drugs.

Science Daily reports that approximately 10 percent of the patients screened positive for unhealthy substance use. Most of these patients had unhealthy alcohol use (72.3 percent). The study found that 75.4 percent of women with unhealthy substance use had a mammogram in the previous two years compared with 83.8 percent who did not engage in unhealthy substance use.

The study also found that 44.7 percent of adults who engaged in unhealthy substance use received a flu shot, compared with 50.4 percent who did not engage in such behavior.

Although the study found unhealthy substance use was associated with lower rates of mammography and flu vaccination, the researchers did not find that unhealthy substance use lowered rates of Pap smears or colon cancer screening.

In the journal BMJ Open, the researchers recommend that mammography screening and flu vaccination be incorporated into other services delivered to individuals with substance-use problems.