This Week in Family Medicine — Aug 10, 2026

Welcome to This Week in Family Medicine. This week we're covering 3 notable papers spanning cancer screening adherence, the primary care role in chronic inflammatory disease, and the recognition of acute deep neck infection in the office. Let's dive in.

We start with a question that dogs every screening programme: how do you get patients back for the second, third, and fourth round? In JAMA Internal Medicine, a pragmatic two-by-two factorial randomised trial at Kaiser Permanente Washington enrolled 1,837 patients who had already completed a low-dose computed tomography lung screen with normal findings, mean age 66, about half currently smoking [2]. Patients were assigned to usual care, a health communication package of print and video messaging aimed at knowledge barriers, a Stepped Reminders intervention, or both. Stepped Reminders worked by pending the next scan order in the primary care physician's inbox and simultaneously nudging the patient to book it, coordinated through an electronic health record registry. The result was one of the largest effects you will see for an adherence intervention: annual screening completion at nine to fifteen months rose from about 47 percent without reminders to about 76 percent with them, an absolute gain of nearly 28 percentage points, and the benefit was even larger among patients who were currently smoking. The health communication arm, by contrast, did not help and in fact was associated with adherence about 5 percentage points lower, a statistically significant harm signal. The lesson is uncomfortable but useful: educating patients about screening was not the missing ingredient, whereas building the order and the outreach into the workflow was. If your practice runs lung screening, invest in registry-driven recall rather than more pamphlets.

Our second theme is the primary care physician as the manager of risk that sits outside the index diagnosis. Annals of Internal Medicine published a clinical review on inflammatory bowel disease that is written squarely for our workflow [1]. The argument is that with global burden rising, the main threats to these patients over decades are not only flares but the downstream consequences of chronic inflammation and long-term immunosuppression: infection, malignancy, bone loss, nutritional deficiency, and mental health disorders. The review sets out structured health care maintenance across vaccination, cancer screening, bone and cardiometabolic health, nutrition, and psychosocial well-being, and it is explicit that this only works when gastroenterology and primary care agree in advance on who owns what. Practically, that means an annual review for the immunosuppressed patient that checks live versus inactivated vaccine eligibility, skin and cervical cancer surveillance, vitamin D and bone density, and mood, rather than assuming the specialist has it covered.

Our third paper shifts from chronic to acute. In BMC Primary Care, a population-based registry study from Region Kronoberg, Sweden, identified 607 episodes of peritonsillitis over five years [3]. Incidence peaked in late adolescence and young adulthood, with no sex difference, and was low in children and the elderly. The key clinical point is that only about a quarter of episodes were preceded by a documented sore throat consultation in the previous 30 days, so peritonsillar abscess frequently arrives without a preceding pharyngotonsillitis in the record. Nearly three quarters were first diagnosed in primary care and most of those were then managed by ear, nose and throat specialists, with 85 percent of all episodes starting in primary care. Do not let the absence of a recent sore throat visit lower your suspicion in a young adult with trismus, unilateral pain, or a muffled voice.

If you only have time for one paper this week, make it the lung cancer screening trial in JAMA Internal Medicine [2]. It is a directly implementable systems fix for a problem nearly every practice has, and it also tells you which intervention to stop funding.

Here are the key takeaways from this week in Family Medicine. First, pended scan orders plus patient outreach raised annual lung screening adherence by roughly 28 percentage points, with the biggest gains in current smokers. Second, patient education messaging alone did not improve adherence and was associated with slightly worse uptake. Third, patients with inflammatory bowel disease need a deliberate, shared preventive care plan covering vaccines, cancer screening, bone health, nutrition and mental health. Fourth, peritonsillitis is a young adult disease that usually presents without a recent documented sore throat, and primary care is where most cases are first identified.

That's your roundup for This Week in Family Medicine. The full transcript and references are available on the episode page in your AudioScholar library. This is an AI-curated summary — for clinical decisions, always consult primary sources and current guidelines. See you next week. One more note before you go: only 3 new papers of note met the bar since the last update — a quieter stretch for new literature. Still worth revisiting from recent updates: Multiorganizational Recommendations for Point-of-Care Ultrasound in Family Medicine Residency Education, in Family Medicine; and Iron deficiency testing among people with incident heart failure in primary care, in BJGP Open.

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This is an automated summary generated by artificial intelligence, which can make mistakes. Always review the original source materials.