title: Access to preventive health care for cancer survivors.
abstract: BACKGROUND
  Access to health care, particularly effective primary and secondary preventive care, is critical for cancer survivors, in order to minimize the adverse sequelae of cancer and its treatment.
  
  
  OBJECTIVE
  The goal of the study was to evaluate the association between cancer survivorship and access to primary and preventive health care.
  
  
  METHODS
  Cancer survivors (n=4960) and individuals without a cancer history (n=64,431) aged ≥ 18 years, from the 2008-2010 Medical Expenditure Panel Survey (MEPS), were evaluated. Multiple measures of access and preventive services use were compared. The association between cancer survivorship and access and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18-64 years and ≥ 65 years), controlling for the effects of age, gender, race/ethnicity, education, marital status, and comorbidities. Data were analyzed in 2013.
  
  
  RESULTS
  Cancer survivors aged ≥ 65 years had equivalent or greater access and preventive services use than individuals without a cancer history, in adjusted analyses. However, among those aged 18-64 years with private health insurance, cancer survivors were more likely than other individuals to have a usual source of care and to use preventive services, whereas uninsured or publicly insured cancer survivors were generally less likely to have a usual source of care and to use preventive services than were uninsured or publicly insured adults without a cancer history.
  
  
  CONCLUSIONS
  Although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
authors: Division of Cancer Control and Population Sciences, Health Services and Economics Branch, National Cancer Institute, Rockville, MD 20850, USA. yabroffr@mail.nih.gov
authors: K
authors: K
authors: Robin Yabroff
authors: Pamela F
authors: PF
authors: Short
authors: Steven
authors: S
authors: Machlin
authors: Emily
authors: E
authors: Dowling
authors: Heather
authors: H
authors: Rozjabek
authors: Chunyu
authors: C
authors: Li
authors: Timothy
authors: T
authors: McNeel
authors: Donatus U
authors: DU
authors: Ekwueme
authors: Katherine S
authors: KS
authors: Virgo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000517:prevention & control* / Q000534:rehabilitation; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D017741:Survivors; D055815:Young Adult
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