Physician visits, patient comorbidities, and mammography use among elderly colorectal cancer survivors.
Physician visits, patient comorbidities, and mammography use among elderly colorectal cancer survivors.
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DOI：
10.1007/s11764-007-0037-7
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发表时间：
2007-12-01
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影响因子：
--
通讯作者：
Virnig, Beth A
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文献类型：
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作者：
Yu, Xinhua;McBean, A Marshall;Virnig, Beth A
简介：超过一百万美国人从结直肠癌中幸存下来。本研究基于竞争性需求模型，调查了结直肠癌幸存者的医生就诊模式、患者合并症和乳房X线摄影的使用情况。使用监测、流行病学和最终结果（SEER）-Medicare关联数据（2003年合并），研究队列包括1973年至1994年确诊的女性结直肠癌患者，这些患者在癌症诊断后存活了5年或更长时间（n = 12,681），和非癌症的比较人口谁没有癌症史，居住在SEER地区在研究period.RESULTS：癌症幸存者有一个显着的6%高乳房X线摄影率在2000年至2001年比匹配的妇女没有癌症史（50比47每100人，分别）。在癌症幸存者中，评估和管理（E&M）的医生访问次数与乳房X光检查率之间存在显着的正相关。更多的E&M医生就诊减少了有和没有其他合并症的患者之间的乳房X线摄影率差异。癌症幸存者谁访问妇科医生的E&M是45%更有可能接受乳房X光检查比那些谁访问只初级保健医生（多变量校正率比，1.45; 95%CI，1.38-1.53）。结论：老年女性结直肠癌幸存者比无癌症史的匹配女性更可能接受乳房X线检查。有多种合并症的患者可能会通过增加E&M的办公室访问次数和访问妇科医生来接受更多的乳房X光检查。初级保健医生应该优先考虑在癌症幸存者中推荐乳房X光检查。
INTRODUCTION: Over a million Americans have survived colorectal cancer. This study examined physician visit patterns, patient comorbidities, and mammography use among colorectal cancer survivors based on the competing demands model.METHODS: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data (2003 merge), study cohorts included female colorectal cancer patients who were diagnosed from 1973 through 1994 and had survived five or more years after the cancer diagnosis (n = 12,681), and a non-cancer comparison population who had no history of cancer and resided in the SEER areas during the study period.RESULTS: Cancer survivors had a significant 6% higher mammography rate during 2000 to 2001 than matched women with no history of cancer (50 vs 47 per 100 persons, respectively). Among cancer survivors, there was a significant and positive association between the number of physician visits for evaluation and management (E&M) and mammography rates. More physician visits for E&M reduced the differences of mammography rates between those with and without additional comorbidities. Cancer survivors who visited gynecologists for E&M were 45% more likely to receive mammograms than those who visited only primary care physicians (multivariate adjusted rate ratio, 1.45; 95% CI, 1.38-1.53).CONCLUSIONS: Elderly female colorectal cancer survivors were more likely to receive mammograms than matched women with no history of cancer.IMPLICATIONS FOR CANCER SURVIVORS: Patients with multiple comorbidities might receive more mammograms by increasing the number of office visits for E&M and by visiting gynecologists. Primary care physicians should increase the priority for recommending mammograms among cancer survivors.