title: Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study.
abstract: BACKGROUND
  Deficiencies in care for cancer survivors may result from unclear roles for primary care providers (PCPs) and oncology specialists in follow-up.
  
  
  OBJECTIVE
  To compare cancer survivors' care to non-cancer controls.
  
  
  METHODS
  Retrospective, longitudinal, controlled study starting 366 days post-diagnosis.
  
  
  METHODS
  Stage 1-3 breast cancer survivors age 65+ diagnosed in 1998 (n = 1961) and matched non-cancer controls (n = 1961).
  
  
  METHODS
  Using the SEER-Medicare database, we examined the number of visits to PCPs, oncology specialists, and other physicians; receipt of influenza vaccination, cholesterol screening, colorectal cancer screening, bone densitometry, and mammography; and whether care receipt was associated with physician mix visited.
  
  
  RESULTS
  Survivors were consistently less likely to receive influenza vaccination, cholesterol screening, colorectal cancer screening, and bone densitometry but more likely to receive mammograms than controls (all p < 0.05). Over time, colorectal cancer screening and mammography decreased and influenza vaccination increased for both groups (all p < 0.0001). Trends over time in care receipt were similar for survivors and controls. In Year 1, survivors had more visits to PCPs but fewer visits to other physicians than controls (both p < 0.05). Over time, survivors' visits to PCPs and other physicians increased and to oncology specialists decreased (all p < 0.0001). Controls' visits to PCPs increased (p < 0.0001) faster than survivors' (p = 0.003). Controls' visits to other physicians increased (p < 0.0001) at a rate similar to survivors. Survivors who visited both a PCP and oncology specialist were most likely to receive each service.
  
  
  CONCLUSIONS
  Better coordination between PCPs and oncology specialists may improve care for older breast cancer survivors.
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD, USA. csnyder@jhsph.edu
authors.forename: Claire F
authors.initials: CF
authors.lastname: Snyder
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Frick
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Peairs
authors.forename: Melinda E
authors.initials: ME
authors.lastname: Kantsiper
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Herbert
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Blackford
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Wolff
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
mesh_terms: D000368:Aged; D015519:Bone Density; D001943:Breast Neoplasms; D002784:Cholesterol / Q000097:blood; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D007252:Influenza Vaccines; D008137:Longitudinal Studies; D008327:Mammography; D008495:Medical Oncology; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D012189:Retrospective Studies; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines; D002784:Cholesterol