Search

Background: Deficiencies in care for cancer survivors may result from unclear roles for primary care providers (PCPs) and oncology specialists in follow-up.Objectives: To compare cancer survivors' care to non-cancer controls.Design: Retrospective, longitudinal, controlled study starting 366 days post-diagnosis.Subjects: Stage 1-3 breast cancer survivors age 65+ diagnosed in 1998 (n = 1961) and matched non-cancer controls (n = 1961).Measurements: Using the SEER-Medicare database, we examined the number of visits to PCPs, oncology specialists, and other physicians; receipt of influenza vaccination, cholesterol screening, colorectal cancer screening, bone densitometry, and mammography; and whether care receipt was associated with physician mix visited.Results: Survivors were consistently less likely to receive influenza vaccination, cholesterol screening, colorectal cancer screening, and bone densitometry but more likely to receive mammograms than controls (all p < 0.05). Over time, colorectal cancer screening and mammography decreased and influenza vaccination increased for both groups (all p < 0.0001). Trends over time in care receipt were similar for survivors and controls. In Year 1, survivors had more visits to PCPs but fewer visits to other physicians than controls (both p < 0.05). Over time, survivors' visits to PCPs and other physicians increased and to oncology specialists decreased (all p < 0.0001). Controls' visits to PCPs increased (p < 0.0001) faster than survivors' (p = 0.003). Controls' visits to other physicians increased (p < 0.0001) at a rate similar to survivors. Survivors who visited both a PCP and oncology specialist were most likely to receive each service.Conclusions: Better coordination between PCPs and oncology specialists may improve care for older breast cancer survivors. [ABSTRACT FROM AUTHOR]

Introduction: More than a third of hospitalized women are overdue or nonadherent to breast cancer screening guidelines, and almost a third of them are also at high risk for developing breast cancer. The purpose of this study is to evaluate the feasibility of coordinating inpatient breast cancer screening mammography for these women before their discharge from the hospital.Methods: A prospective intervention study was conducted among 101 nonadherent women aged 50-74 years who were hospitalized to a general medicine service. Sociodemographic, reproductive history, family history of breast cancer, and medical comorbidities data were collected for all patients from January 2015 to October 2016. The data were analyzed in March 2018. Fisher's exact tests and unpaired t-tests were utilized to compare the characteristics of the study population.Results: Of the 101 women enrolled who were nonadherent to breast cancer screening recommendations, their mean age was 59.3 (SD=6) years, the mean 5-year Gail risk score was 1.63 (SD=0.69), and 29% of the women were African American. Almost 80% (n=79) underwent inpatient screening mammography. All women who underwent screening mammography during their inpatient stay were extremely satisfied with the experience. The convenience of having screening mammography while hospitalized was reported to be a major facilitator of completing the overdue screening. All nurses (100%) taking care of these women believed that this practice should become part of the standard of care, and most hospitalist physicians (66%) agreed that this practice is feasible.Conclusions: This study shows that it is possible to coordinate mammography for hospitalized women who were overdue for screening and at high risk for developing breast cancer.Trial Registration: This study is registered at www.clinicaltrials.gov NCT04164251. [ABSTRACT FROM AUTHOR]