Physician visits, patient comorbidities, and mammography use among elderly colorectal cancer survivors.
BACKGROUND
Over a million Americans have survived colorectal cancer. This study examined physician visit patterns, patient comorbidities, and mammography use among colorectal cancer survivors based on the competing demands model.


METHODS
Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data (2003 merge), study cohorts included female colorectal cancer patients who were diagnosed from 1973 through 1994 and had survived five or more years after the cancer diagnosis (n = 12,681), and a non-cancer comparison population who had no history of cancer and resided in the SEER areas during the study period.


RESULTS
Cancer survivors had a significant 6% higher mammography rate during 2000 to 2001 than matched women with no history of cancer (50 vs 47 per 100 persons, respectively). Among cancer survivors, there was a significant and positive association between the number of physician visits for evaluation and management (E&M) and mammography rates. More physician visits for E&M reduced the differences of mammography rates between those with and without additional comorbidities. Cancer survivors who visited gynecologists for E&M were 45% more likely to receive mammograms than those who visited only primary care physicians (multivariate adjusted rate ratio, 1.45; 95% CI, 1.38-1.53).


CONCLUSIONS
Elderly female colorectal cancer survivors were more likely to receive mammograms than matched women with no history of cancer.


CONCLUSIONS
Patients with multiple comorbidities might receive more mammograms by increasing the number of office visits for E&M and by visiting gynecologists. Primary care physicians should increase the priority for recommending mammograms among cancer survivors.
Yu
Xinhua
X
Division of Health Policy and Management, University of Minnesota School of Public Health, MMC 97, 420 Delaware St., S.E., Minneapolis, MN 55455, USA. xinhuayu@umn.edu
McBean
A Marshall
AM
Virnig
Beth A
BA
D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications* / Q000453:epidemiology; D015897:Comorbidity / Q000639:trends*; D005260:Female; D006801:Humans; D007182:Income; D008327:Mammography / Q000706:statistics & numerical data*; D016344:Medicare Part A / Q000706:statistics & numerical data*; D016345:Medicare Part B / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data*; D044469:Racial Groups; D017741:Survivors; D014481:United States