Trends in follow-up and preventive care for colorectal cancer survivors

BACKGROUND: As cancer patients transition from treatment to survivorship, the responsibility of primary care providers (PCPs) versus oncology specialists is unclear. OBJECTIVES: To explore (1) physician types (PCPs versus oncology specialists) survivors visit during survivorship year 1, (2) preventive care received, (3) how preventive care receipt relates to physician types visited, and (4) trends in physician types visited and preventive care received over time. DESIGN: Retrospective cross-sectional study of 5 cohorts of cancer survivors in survivorship year 1. SUBJECTS: Twenty thousand sixty-eight survivors diagnosed with stage 1-3 colorectal cancer between 1997 and 2001. MEASUREMENTS: Using the SEER-Medicare database, we assessed the mean number of visits to different physician types, the percentage of survivors receiving preventive services, how receipt of preventive services related to physician types visited, and trends over time in physician visits and preventive care. RESULTS: There was a trend over time of increased visits to all physician types, which was statistically significant for oncology specialists and other physicians (p <.001) but not PCPs. The percentage of survivors receiving preventive services remained relatively stable across the 5 cohorts, except for an increase in bone densitometry (p <.05). Survivors who visited both a PCP and oncology specialist were most likely to receive each preventive care service (p <.05). CONCLUSIONS: Oncology specialist follow-up in survivorship year 1 is intensifying over time. Survivors not being followed-up by both PCPs and oncology specialists were less likely to receive preventive care. Clarifying the roles of PCPs and oncology specialists during follow-up can improve the quality of care for survivors.