Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
J Cancer Surviv. 2011 Sep;5(3):283-91. doi: 10.1007/s11764-011-0181-y. Epub 2011 May 8.
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.
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.
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).
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.
PCP involvement in prostate cancer patients' care is critical both during treatment and for long-term survivors.
前列腺癌是最常见的男性癌症。存活率较高，因此预防保健很重要。需要研究与短期（第 1 年）和长期（第 5 年）前列腺癌病例预防保健相关的因素，以及与非癌症对照相比，幸存者的护理情况如何。
本回顾性、对照 SEER-Medicare 研究纳入了在 2000 年接受过按服务收费 Medicare 治疗、年龄≥66 岁、局部区域前列腺癌诊断后存活时间≥12 个月的局部区域前列腺癌病例，以及与病例按社会人口统计学和生存情况相匹配的非癌症对照。结果包括流感疫苗接种、胆固醇筛查和结直肠癌筛查。自变量包括就诊次数、就诊医生专业、初始前列腺癌治疗、社会人口统计学特征以及病例对照状态。
第 1 年有 13507 例病例和 13507 例对照，第 5 年有 10482 例病例和 10482 例对照。在第 1 年和第 5 年，就诊总次数（6/6 项结果）和初级保健医生（PCP）就诊次数（5/6 项结果）与预防保健的获得最一致相关。在第 1 年，前列腺癌病例比对照更有可能接种流感疫苗（48%比 45%），但不太可能接受结直肠癌筛查（29%比 31%）（均 P<0.0001）。在第 5 年，前列腺癌病例仍比对照更有可能接种流感疫苗（46%比 44%；P<0.0001）。
幸存者短期预防保健的差异并未导致长期预防保健的恶化。就诊次数，特别是 PCP 就诊次数，是与适当护理相关的重要因素。
在治疗期间和长期幸存者中，初级保健医生参与前列腺癌患者的护理至关重要。
