Preventive care in prostate cancer patients: following diagnosis and for five-year survivors.

INTRODUCTION

Prostate cancer is the most common male cancer. Survival rates are high, making preventive care maintenance important. Factors associated with prostate-cancer cases' preventive care in the short-term (Year 1) and long-term (Year 5), and how survivors' care compares to non-cancer controls, require study.

METHODS

This retrospective, controlled SEER-Medicare study included loco-regional prostate cancer cases age ≥ 66 in fee-for-service Medicare diagnosed in 2000 and surviving ≥ 12 months, and non-cancer controls matched to cases on socio-demographics and survival. Outcomes included influenza vaccination, cholesterol screening, and colorectal cancer screening. Independent variables were number of physician visits, physician specialties visited, initial prostate cancer treatment, socio-demographic characteristics, and case-control status.

RESULTS

There were 13,507 cases and 13,507 controls in Year 1, and 10,482 cases and 10,482 controls in Year 5. In Years 1 and 5, total number of visits (6/6 outcomes) and primary care provider (PCP) visits (5/6 outcomes) were most consistently associated with preventive care receipt. In Year 1, prostate cancer cases were more likely than controls to receive influenza vaccination (48% vs. 45%) but less likely to receive colorectal cancer screening (29% vs. 31%) (both p  <  0.0001). In Year 5, prostate cancer cases remained more likely than controls to receive influenza vaccination (46% vs. 44%; p  <  0.0001).

CONCLUSIONS

Differences in survivors' short-term preventive care did not lead to worse long-term preventive care. The number of physician visits, particularly PCP visits, are important factors associated with appropriate care.

IMPLICATIONS FOR CANCER SURVIVORS

PCP involvement in prostate cancer patients' care is critical both during treatment and for long-term survivors.