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Preventive services use among female survivors of adolescent and young adult cancer

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Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

Examine preventive services utilization among female survivors of adolescent and young adult (AYA) cancer compared with women without cancer in the USA.

Methods

A total of 1017 women diagnosed with cancer at AYA ages (15–39 years) who were at least 5 years since diagnosis were identified from 2008 to 2012 Medical Expenditure Panel Surveys. A comparison group without cancer was matched on age and other characteristics. General preventive services included dental, medical, blood pressure, and cholesterol checkups, and flu shots in the previous year. Cancer-related services included pap smear and mammography. Preventive services and covariates (demographics, socioeconomics, and health status) were compared between groups using χ 2 tests. Ordinal logistic regression identified covariates associated with general preventive services use.

Results

Female survivors reported dental checkups less often (57.8 vs. 72.4 %, p < 0.001) than the comparison group and checked their blood pressure (90 vs. 86.7 %, p = 0.045) and cholesterol (67.5 vs. 61.7 %, p = 0.045) more often. No differences were found in flu shots, medical checkups, and cancer-related services. Survivors without insurance were less likely to use general preventive services (odds ratio [OR] = 0.2, 95 % confidence interval [CI] 0.12–0.35, p < 0.001). Older survivors (OR = 3.09, 95 % CI 1.69–5.62, p < 0.001) and those who speak Spanish or other languages at home (OR = 3.19, 95 % CI 1.33–7.67, p = 0.01) were more likely to use general prevention than their counterparts.

Conclusion

Overall, female survivors were as likely as the comparison group to use preventive services, except dental services, blood pressure, and cholesterol checks.

Implications for Cancer Survivors

Survivors may require support to use recommended preventive services more effectively, especially the younger and uninsured who may be at greater risk for underuse.

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References

  1. Office of Disease Prevention ad Health Promotion. Leading Health Indicators: Clinical Preventive Services. Healthy People 2020. https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Clinical-Preventive-Services. Accessed April 2016.

  2. “Coverage of Certain Preventive Services under the Affordable Care Act”. Federal Register, v. 80, n. 134; July 2015.

  3. Agency for Healthcare Research and Quality. Guide to Clinical Preventive services, 2014. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/preface.html. Accessed April 2016.

  4. U.S. Preventive Services Task Force. Evidence Summary: Collaborative Modeling of U.S. Breast Cancer Screening Strategies. 2016. http://www.uspreventiveservicestaskforce.org/Page/Document/evidence-summary-collaborative-modeling-of-us-breast-cancer-/breast-cancer-screening1. Accessed May 2016.

  5. Centers for Disease Control and Prevention. Seasonal Influenza Vaccine Effectiveness, 2005-2016. http://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm. Accessed May 2016.

  6. Hensrud DD. Clinical preventive medicine in primary care: background and practice: 1. Rationale and current preventive practices. Mayo Clin Proc. 2000;75(2):165–72.

    Article  CAS  PubMed  Google Scholar 

  7. Maciosek MV, Coffield AB, Edwards NM, et al. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006;31(1):52–61.

    Article  PubMed  Google Scholar 

  8. McGlynn EA, Asch SM, Adams J, et al. The Quality of Health Care Delivered to Adults in the United States. New Engl J Med. 2003;348(26):2635–45.

    Article  PubMed  Google Scholar 

  9. Statistical Office of the European Union- EUROSTAT. Healthcare Expenditures by Function, 2012. Healthcare Expenditures Statistics. 2015. http://ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_expenditure_statistics#Healthcare_expenditure_by_function. Accessed June 2016.

  10. Homan SG, Kayani N, Yun S. Risk factors, preventive practices, and health care among breast cancer survivors, United States, 2010. Prev Chronic Dis. 2016;13:E09.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101(8):1712–9.

    Article  PubMed  Google Scholar 

  12. Findley PA, Sambamoorthi U. Preventive health services and lifestyle practices in cancer survivors: a population health investigation. J Cancer Surviv. 2009;3(1):43–58.

    Article  PubMed  Google Scholar 

  13. Nakamura S, Narimatsu H, Ito Sasahara Y, et al. Health management in cancer survivors: findings from a population-based prospective cohort study-the Yamagata Study (Takahata). Cancer Sci. 2015;106(11):1607–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. National Comprehensive Cancer Network (NCCN). Adolescent and Young adult (AYA) oncology. NCCN clinical practice guidelines in oncology. Version 1.2016, 2015. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#age. Accessed in May 2016.

  15. Phillips-Salimi CR, Andrykowski MA. Physical and mental health status of female adolescent/young adult survivors of breast and gynecological cancer: a national, population-based, case-control study. Support Care Cancer. 2013;21(6):1597–604.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kirchhoff AC, Lyles CR, Fluchel M, et al. Limitations in health care access and utilization among long-term survivors of adolescent and young adult cancer. Cancer. 2012;118(23):5964–72.

    Article  PubMed  Google Scholar 

  17. Tai E, Buchanan N, Townsend J, et al. Health status of adolescent and young adult cancer survivors. Cancer. 2012;118(19):4884–91.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kaul S, Fluchel M, Spraker-Perlman H, et al. Health care experiences of long-term survivors of adolescent and young adult cancer. Support Care Cancer. 2016;24(9): 3967–3977.

  19. Kaul S, Fair D, Wright J, Kirchhoff A. Barriers to dental care for survivors of adolescent and young adult cancer. J Adolesc Young Adult Oncol. 2016, ahead of print.

  20. Bertakis K et al. Gender differences in the utilization of health care services. J Fam Practice. 2000;49(2):147–52.

    CAS  Google Scholar 

  21. Cohen JW, Cohen SB, Banthin JS. The medical expenditure panel survey: a national information resource to support healthcare cost research and inform policy and practice. Med Care. 2009;47(7 Suppl 1):S44–50.

    Article  PubMed  Google Scholar 

  22. Household Component Response Rates by Panel. Medical Expenditures Panel Survey. http://meps.ahrq.gov/mepsweb/survey_comp/hc_response_rate.jsp. Accessed April 2016.

  23. Caliendo M, Kopeinig S. Some practical guidance for the implementation of propensity score matching. J Econ Surv. 2008;22(1):31–72.

  24. Kaul S, Veeranki SP, Rodriguez AM, Kuo YF. Cigarette smoking, comorbidity and general health among survivors of adolescent and young adult cancer. Cancer. 2016, ahead of print.

  25. Final Recommendation Statement: Cervical Cancer: Screening. U.S. Preventive Services Task Force. October 2014. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/cervical-cancer-screening. Accessed April 2016.

  26. Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: systematic evidence review update for the US Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US). 2009 Nov. (Evidence Syntheses, No. 74.) http://www.ncbi.nlm.nih.gov/books/NBK36392/. Accessed April 2016 .

  27. MEPS HC-036: 1996–2007 Pooled estimation file. 2009; b AU6 . http://meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h36/h36u07doc.shtml. Accessed April 2016.

  28. Machlin S, Yu W, Zodet M. Computing standard errors for b AU6 MEPS estimates. http://meps.ahrq.gov/survey_comp/standard_errors.jsp. Accessed April 2016.

  29. Williams R. Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata J. 2006;6(1):58–82.

    Google Scholar 

  30. Nass SJ, Beaupin LK, Demark-Wahnefried W, et al. Identifying and addressing the needs of adolescents and young adults with cancer: summary of an Institute of Medicine Workshop. Oncologist. 2015;20(2):186–95.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Corbie-Smith G, Flagg EW, Doyle JP, O’Brien MA. Influence of usual source of care on differences by race/ethnicity in receipt of preventive services. J Gen Intern Med. 2002;17(6):458–64.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Yaghjyan L, Wolin K, Chang SH, Colditz G. Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005. Cancer Causes Control. 2014;25(5):605–14.

    Article  PubMed  PubMed Central  Google Scholar 

  33. O’Malley AS, Mandelblatt J, Gold K, et al. Continuity of care and the use of breast and cervical cancer screening services in a multiethnic community. Arch Intern Med. 1997;157(13):1462–70.

    Article  PubMed  Google Scholar 

  34. Runowicz CD, Leach CR, Henry NL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol. 2016;34(6):611–35.

    Article  CAS  PubMed  Google Scholar 

  35. Massad LS, Einstein MH, Huh WK, et al, for the 2012 American Society for Colposcopy and Cervical Pathology Consensus Guidelines Conference. 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2013; 17(5). Accessed in May 2016 from: http://www.asccp.org/guidelines.

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Acknowledgments

Results from an earlier version of this manuscript were presented as posters at the University of Texas Medical Branch’s Institute of Translational Sciences Symposium and Center of Interdisciplinary Research in Women’s Health. We thank participants at these symposiums for their helpful comments.

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Authors and Affiliations

  1. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd., Ewing Hall, Galveston, TX, 77555, USA

    Jaqueline C. Avila, Yong-Fang Kuo, Rebeca Wong & Sapna Kaul

  2. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA

    Ana M. Rodriguez

Authors
  1. Jaqueline C. Avila
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  2. Yong-Fang Kuo
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  3. Ana M. Rodriguez
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Correspondence to Jaqueline C. Avila.

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Avila, J.C., Kuo, YF., Rodriguez, A.M. et al. Preventive services use among female survivors of adolescent and young adult cancer. J Cancer Surviv 11, 167–174 (2017). https://doi.org/10.1007/s11764-016-0575-y

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  • DOI: https://doi.org/10.1007/s11764-016-0575-y

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