Cancer screening and preventative care among long-term cancer survivors in the United Kingdom.
BACKGROUND
Long-term cancer survivors in the United Kingdom are mostly followed up in a primary care setting by their general practitioner; however, there is little research on the use of services. This study examines whether cancer survivors receive adequate screening and preventative care in UK primary care.


METHODS
We identified a cohort of long-term survivors of breast, colorectal and prostate cancer with at least a 5-year survival using the General Practice Research Database, with controls matched for age, gender and practice. We compared adherence with cancer screening and the use of preventative care between cancer survivors and controls.


RESULTS
The cancer survivors' cohort consisted of 18 612 breast, 5764 colorectal and 4868 prostate cancer survivors. Most cancer survivors receive cancer screening at the same levels as controls, except for breast cancer survivors who were less likely to receive a mammogram than controls (OR=0.78, 95% CI: 0.66-0.92). Long-term cancer survivors received comparable levels of influenza vaccinations and cholesterol tests, but breast (OR 0.81, 95% CI: 0.74-0.87) and prostate cancer survivors (OR=0.70, 95% CI: 0.57-0.87) were less likely to receive a blood pressure test. All survivors were more likely to receive bone densitometry.


CONCLUSIONS
The provision and uptake of preventive care in a primary care setting in the United Kingdom is comparable between the survivors of three common cancers and those who have not had cancer. However, long-term breast cancer survivors in this cohort were less likely to receive a mammogram.
Department of Primary Health Care, University of Oxford, Oxford, UK. nada.khan@dphpc.ox.ac.uk
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Khan
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Carpenter
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Watson
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Rose
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D011322:Primary Prevention; D011471:Prostatic Neoplasms / Q000453:epidemiology; D017741:Survivors; D006113:United Kingdom / Q000453:epidemiology