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Examining colorectal cancer survivors’ surveillance patterns and experiences of care: a SEER-CAHPS study

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Abstract

Purpose

We examined associations between experiences of care and adherence to surveillance guidelines among Medicare Fee-For-Service beneficiaries with colorectal cancer (CRC).

Methods

Using linked data from the National Cancer Institute’s Surveillance, Epidemiology, and End results (SEER) cancer registry program and the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient experience surveys (SEER-CAHPS), we identified local/regional CRC survivors diagnosed in 1999–2009 aged 65+, who underwent surgical resection and completed a CAHPS survey <36 months of diagnosis. Adherence for a 3-year observation period was defined as receiving a colonoscopy; ≥2 carcinoembryonic antigen (CEA) tests; and each year had ≥2 office visits and ≥1 computerized tomography test.

Results

Many of the 314 participants reported ratings of a 9 or 10 out of 10 for overall care (55.4%), personal doctor (58.6%), health plan (59.6%), and specialist doctor (47.0%). Adherence to post-resection surveillance was 76.1% for office visits, 36.9% for CEA testing, 48.1% for colonoscopy, and 10.3% for CT Imaging. Overall, 37.9% of the sample were categorized as non-adherent (adhering to ≤1 surveillance guideline). In multivariable models, ratings of personal doctor and specialist doctor were positively associated with adherence to office visits, and ratings of personal doctor were associated with adherence overall.

Conclusions

Findings point to the potentially important role of patient-provider relationships in adherence to office visits for CRC surveillance. As adherence may increase survival among CRC survivors, further investigation is needed to identify specific components of this relationship that impact office visit adherence, and other potentially modifiable drivers of surveillance guidelines.

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Disclaimer

The article was prepared as part of some of the authors’ (MAM, LE, EEK) official duties as employees of the US Federal Government. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Cancer Institute.

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Authors and Affiliations

  1. Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA

    Michelle A. Mollica, Lindsey R. Enewold & Erin E. Kent

  2. Research Triangle Institute, Waltham, MA, USA

    Lisa M. Lines & Michael T. Halpern

  3. Department of Surgery, University of Wisconsin, Madison, WI, USA

    Jessica R. Schumacher

  4. Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Ron D. Hays

  5. Information Management Services, Rockville, MD, USA

    James T. Gibson & Nicola Schussler

Authors
  1. Michelle A. Mollica
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  2. Lindsey R. Enewold
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  9. Erin E. Kent
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Correspondence to Michelle A. Mollica.

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Mollica, M.A., Enewold, L.R., Lines, L.M. et al. Examining colorectal cancer survivors’ surveillance patterns and experiences of care: a SEER-CAHPS study. Cancer Causes Control 28, 1133–1141 (2017). https://doi.org/10.1007/s10552-017-0947-2

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  • DOI: https://doi.org/10.1007/s10552-017-0947-2

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