The relationship between continuity of care and trust with stage of cancer at diagnosis.
OBJECTIVE
While continuity of care has been associated with an increased rate of cancer screening, it is unclear if continuity leads to earlier detection of cancer. This study examined the relationship between continuity of care and trust in one's physician with stage of cancer among newly diagnosed colorectal and breast cancer patients.


METHODS
A total of 119 newly diagnosed cancer patients (97 breast, 22 colorectal) were surveyed in face-to-face interviews. The relationship between continuity of care and trust with the patient's primary care physicians prior to diagnosis were examined in relationship to the patient's stage at diagnosis via Spearman correlations and chi-square analyses. A stepwise logistic regression model was computed to examine the best predictors of stage at diagnosis.


RESULTS
Half of the patients reported that their cancer was found through screening. Continuity of care prior to diagnosis was related to receiving mammography. Continuity of care was not, however, significantly related to earlier detection. Trust in one's primary care physician was related to earlier detection among both the entire sample of patients with colon and breast cancer and among a subsample of women with breast cancer. In a multivariate model, only detection through screening and trust predicted stage of diagnosis.


CONCLUSIONS
Continuity of care is not related to earlier detection of cancer, while trust with a regular physician was associated with earlier detection of cancer.
Mainous
Arch G
AG
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. mainouag@musc.edu
Kern
Donna
D
Hainer
Berry
B
Kneuper-Hall
Rayna
R
Stephens
Julie
J
Geesey
Mark E
ME
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000523:psychology*; D003266:Continuity of Patient Care; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010817:Physician-Patient Relations; D013997:Time Factors; D035502:Trust / Q000523:psychology*