Original Article

Journal of General Internal Medicine

, Volume 23, Issue 3, pp 254-259

First online:

Trends in Follow-up and Preventive Care for Colorectal Cancer Survivors

  • Claire F. SnyderAffiliated withDivision of General Internal Medicine, Department of Medicine, Johns Hopkins School of MedicineDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthDepartment of Oncology, Johns Hopkins School of Medicine Email author 
  • , Craig C. EarleAffiliated withDivision of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute
  • , Robert J. HerbertAffiliated withDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
  • , Bridget A. NevilleAffiliated withDivision of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute
  • , Amanda L. BlackfordAffiliated withDepartment of Oncology, Johns Hopkins School of Medicine
  • , Kevin D. FrickAffiliated withDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health

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Abstract

Background

As cancer patients transition from treatment to survivorship, the responsibility of primary care providers (PCPs) versus oncology specialists is unclear.

Objectives

To explore (1) physician types (PCPs versus oncology specialists) survivors visit during survivorship year 1, (2) preventive care received, (3) how preventive care receipt relates to physician types visited, and (4) trends in physician types visited and preventive care received over time.

Design

Retrospective cross-sectional study of 5 cohorts of cancer survivors in survivorship year 1.

Subjects

Twenty thousand sixty-eight survivors diagnosed with stage 1–3 colorectal cancer between 1997 and 2001.

Measurements

Using the SEER-Medicare database, we assessed the mean number of visits to different physician types, the percentage of survivors receiving preventive services, how receipt of preventive services related to physician types visited, and trends over time in physician visits and preventive care.

Results

There was a trend over time of increased visits to all physician types, which was statistically significant for oncology specialists and other physicians (p < .001) but not PCPs. The percentage of survivors receiving preventive services remained relatively stable across the 5 cohorts, except for an increase in bone densitometry (p < .05). Survivors who visited both a PCP and oncology specialist were most likely to receive each preventive care service (p < .05).

Conclusions

Oncology specialist follow-up in survivorship year 1 is intensifying over time. Survivors not being followed-up by both PCPs and oncology specialists were less likely to receive preventive care. Clarifying the roles of PCPs and oncology specialists during follow-up can improve the quality of care for survivors.

KEY WORDS

preventive care cancer survivors coordination of care