Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown Center, Boston, MA, 02118, USA.
Harvard Medical School, Boston, MA, USA.
J Cancer Surviv. 2022 Apr;16(2):445-454. doi: 10.1007/s11764-021-01039-1. Epub 2021 Apr 14.
The purpose of this study was to examine receipt of follow-up surveillance among sexual minority and heterosexual survivors and identify survivor-, physician-, and practice-level characteristics associated with follow-up surveillance.
An average of 3 years after their stage I-III colorectal cancer diagnosis, we recruited survivors from four cancer registries. A questionnaire, which queried about sexual orientation and other eligibility criteria, was mailed to all cancer survivors. Subsequently, 418 eligible survivors without recurrent disease participated in a telephone survey. Colorectal cancer-specific follow-up surveillance was defined as colonoscopy, carcinoembryonic antigen (CEA) test, or imaging test. We used logistic regression with forward selection to obtain models that best explained each follow-up test.
About 10% of survivors received no follow-up surveillance, while 70% had colonoscopies. While survivors irrespective of sexual orientation received follow-up surveillance, sexual minority survivors had 3 times the odds of receiving imaging tests compared to heterosexual survivors. Having a designated provider of any specialty was most salient for the receipt of surveillance.
Sexual minority survivors' greater receipt of imaging tests may indicate providers perceive them at greater risk for recurrence than heterosexual survivors. Future studies need to examine provider behaviors towards monitoring colorectal cancer survivors of diverse sexual orientations.
Guidelines recommend surveillance of colorectal cancer survivors to improve survival. This study showed that having a designated provider for follow-up is most salient for the receipt of surveillance, most survivors receive surveillance, and sexual minority survivors had more imaging tests compared to heterosexual survivors.
本研究旨在检查性少数群体和异性恋幸存者的随访监测情况，并确定与随访监测相关的幸存者、医生和实践水平特征。
在他们的 I-III 期结直肠癌诊断后平均 3 年，我们从四个癌症登记处招募了幸存者。向所有癌症幸存者邮寄了一份调查问卷，询问其性取向和其他资格标准。随后，418 名符合条件且无复发疾病的幸存者参加了电话调查。结直肠癌特异性随访监测定义为结肠镜检查、癌胚抗原（CEA）测试或影像学检查。我们使用向前选择的逻辑回归来获得最佳解释每种随访测试的模型。
约 10%的幸存者未接受任何随访监测，而 70%的幸存者接受了结肠镜检查。无论其性取向如何，幸存者都接受了随访监测，但与异性恋幸存者相比，性少数幸存者接受影像学检查的可能性是其 3 倍。有任何专科指定的提供者对接受监测最为重要。
性少数幸存者接受影像学检查的比例较高，可能表明提供者认为他们比异性恋幸存者更有可能复发。未来的研究需要检查不同性取向的结直肠癌幸存者的监测行为。
指南建议对结直肠癌幸存者进行监测以提高生存率。本研究表明，有指定的随访提供者对接受监测最为重要，大多数幸存者接受了监测，而且与异性恋幸存者相比，性少数幸存者接受了更多的影像学检查。
