Prevention, Screening, and Surveillance Care for Breast Cancer Survivors Compared With Controls: Changes from 1998 to 2002
Prevention, Screening, and Surveillance Care for Breast Cancer Survivors Compared With Controls: Changes from 1998 to 2002
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DOI：
10.1200/jco.2008.18.0950
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发表时间：
2009-03-01
影响因子：
45.3
通讯作者：
Earle, Craig C.
中科院分区：
文献类型：
--
作者：
Snyder, Claire F.;Frick, Kevin D.;Earle, Craig C.
PurposeTo研究如何照顾乳腺癌幸存者比较controls.Patients和MethodsUsing的监测，流行病学，和最终结果，医疗数据库，我们研究了5个队列的阶段1至3乳腺癌幸存者诊断1998年至2002年。对于每个幸存者队列（按诊断年份定义），我们计算了肿瘤专家、初级保健提供者（PCP）和其他医生的就诊次数，以及在生存期第1年（诊断后366至730天）接受流感疫苗接种、胆固醇筛查、结直肠癌筛查、骨密度测定和乳房X光检查的百分比。我们将幸存者的护理与5个年龄、种族、性别和地区与幸存者相匹配的筛查对照组以及5个年龄、种族、性别、地区和合并症相匹配的合并症对照组进行了比较。我们研究了幸存者的护理是否与医生专业的组合，visited.ResultsA共23,731名幸存者与23,731名筛选对照和23,396名合并症对照相匹配。幸存者和任何对照组之间PCP就诊的趋势随时间推移没有差异。幸存者的其他医生就诊的增加率高于筛选对照组（P = 0.002），但与合并症对照组没有差异。幸存者接受预防性治疗的可能性低于筛选对照组，但高于合并症对照组。随着时间的推移，幸存者的护理趋势往往优于筛选对照，但与合并症对照没有差异。幸存者谁访问了PCP和肿瘤专家最有可能接受推荐的treatment.ConclusionInvolvement由PCP和肿瘤专家可以促进适当的照顾幸存者。J Clin Oncol 27：1054-1061. (C)2009年美国临床肿瘤学会
PurposeTo examine how care for breast cancer survivors compares with controls.Patients and MethodsUsing the Surveillance, Epidemiology, and End Results-Medicare database, we examined five cohorts of stages 1 to 3 breast cancer survivors diagnosed from 1998 to 2002. For each survivor cohort (defined by diagnosis year), we calculated the number of visits to oncology specialists, primary care providers (PCPs), and other physicians and the percentage who received influenza vaccination, cholesterol screening, colorectal cancer screening, bone densitometry, and mammography during survivorship year 1 (days 366 to 730 postdiagnosis). We compared survivors' care to that of five cohorts of screening controls who were matched to survivors on age, ethnicity, sex, and region and who had a mammogram in the survivor's year of diagnosis and to that of five cohorts of comorbidity controls who were matched on age, ethnicity, sex, region, and comorbidity. We examined whether survivors' care was associated with the mix of physician specialties that were visited.ResultsA total of 23,731 survivors were matched with 23,731 screening controls and 23,396 comorbidity controls. There was no difference in trends over time in PCP visits between survivors and either control group. The survivors' rate of increase in other physician visits was greater than screening controls (P = .002) but was no different from comorbidity controls. Survivors were less likely to receive preventive care than screening controls but were more likely than comorbidity controls. Trends over time in survivors' care tended to be better than screening controls but were no different than comorbidity controls. Survivors who visited both a PCP and oncology specialist were most likely to receive recommended care.ConclusionInvolvement by both PCPs and oncology specialists can facilitate appropriate care for survivors. J Clin Oncol 27: 1054-1061. (C) 2009 by American Society of Clinical Oncology