Abstract
Introduction
Prostate cancer is the most common male cancer. Survival rates are high, making preventive care maintenance important. Factors associated with prostate-cancer cases’ preventive care in the short-term (Year 1) and long-term (Year 5), and how survivors’ care compares to non-cancer controls, require study.
Methods
This retrospective, controlled SEER-Medicare study included loco-regional prostate cancer cases age ≥66 in fee-for-service Medicare diagnosed in 2000 and surviving ≥12 months, and non-cancer controls matched to cases on socio-demographics and survival. Outcomes included influenza vaccination, cholesterol screening, and colorectal cancer screening. Independent variables were number of physician visits, physician specialties visited, initial prostate cancer treatment, socio-demographic characteristics, and case–control status.
Results
There were 13,507 cases and 13,507 controls in Year 1, and 10,482 cases and 10,482 controls in Year 5. In Years 1 and 5, total number of visits (6/6 outcomes) and primary care provider (PCP) visits (5/6 outcomes) were most consistently associated with preventive care receipt. In Year 1, prostate cancer cases were more likely than controls to receive influenza vaccination (48% vs. 45%) but less likely to receive colorectal cancer screening (29% vs. 31%) (both p < 0.0001). In Year 5, prostate cancer cases remained more likely than controls to receive influenza vaccination (46% vs. 44%; p < 0.0001).
Conclusions
Differences in survivors’ short-term preventive care did not lead to worse long-term preventive care. The number of physician visits, particularly PCP visits, are important factors associated with appropriate care.
Implications for Cancer Survivors
PCP involvement in prostate cancer patients’ care is critical both during treatment and for long-term survivors.
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Acknowledgement
This research was funded through the Ho Ching Yang Memorial Faculty Fellowship Award from the Johns Hopkins Bloomberg School of Public Health. Drs. Snyder and Carducci are also supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-08-011-01-CPPB). Dr. Carducci is also supported by a National Cancer Institute Center Grant (5P30CA006973).
We appreciate the assistance of Hsin-Chieh (Jessica) Yeh, PhD, Core Faculty of the Johns Hopkins General Internal Medicine Methods Core in preparing the data for analysis. This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.
Conflicts of interest
The authors have no relationships with for-profit companies relevant to the subject matter addressed in this manuscript.
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Snyder, C.F., Frick, K.D., Herbert, R.J. et al. Preventive care in prostate cancer patients: following diagnosis and for five-year survivors. J Cancer Surviv 5, 283–291 (2011). https://doi.org/10.1007/s11764-011-0181-y
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DOI: https://doi.org/10.1007/s11764-011-0181-y