title: Routine preventive care and cancer surveillance in long-term survivors of colorectal cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol LTS-01.
abstract: OBJECTIVE
  National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol LTS-01 examines routine preventive care and cancer surveillance in long-term colorectal cancer (CRC) survivors previously treated in NSABP adjuvant trials.
  
  
  METHODS
  Long-term CRC survivors (≥5 years) from five completed NSABP trials (Protocols C-05, C-06, C-07, R-02, and R-03) at 60 study sites were recruited and surveyed using preventive health care items from the National Health Interview Survey (NHIS). A 3:1 comparison cohort case-matched by age, sex, race, and education was created from the 2005 NHIS. Contingency tables and multivariate models were used to compare cohorts and determine predictors of preventive care and cancer surveillance.
  
  
  RESULTS
  A total of 708 patients in protocol LTS-01 (681 patients with colon cancer, 27 patients with rectal cancer) completed the interview: 57.1% male, mean age 66.2 years (standard deviation=10.6), median survival 8 years. Patients in the LTS-01 protocol were more likely to have a usual source of health care (97.7% v 93.8%, P<.0001), have received a flu shot in the past 12 months (67.5% v 44.3%, P<.0001), and have undergone cancer screening by Pap smear (67.3% v 54.8%, P<.0001), mammogram (80.4% v 70.7%, P<.0001), and prostate-specific antigen test (84.5% v 74.5%, P<.0001) than patients in the NHIS cohort. For CRC surveillance, 96.5% of patients in protocol LTS-01 had a colonoscopy, 88.2% had a carcinoembryonic antigen test, and 66.4% had a computed tomography scan in the previous 5 years. Health insurance was the best predictor of cancer screening for all three methods (odds ratio=2.6 to 4.5). No factor was uniformly associated with CRC surveillance.
  
  
  CONCLUSIONS
  This select population of long-term CRC survivors who participated in clinical trials achieved better routine preventive care and cancer screening than the general population and high rates of cancer surveillance.
authors.affiliation: University of California, LosAngeles, CA, USA. hkunitake@hotmail.com
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kunitake
authors.forename: Ping
authors.initials: P
authors.lastname: Zheng
authors.forename: Greg
authors.initials: G
authors.lastname: Yothers
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Land
authors.forename: Louis
authors.initials: L
authors.lastname: Fehrenbacher
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Giguere
authors.forename: D Lawrence
authors.initials: DL
authors.lastname: Wickerham
authors.forename: Lawrence
authors.initials: L
authors.lastname: Wickerham
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D017741:Survivors