title: The impact of primary care physicians on follow-up care of underserved breast cancer survivors.
abstract: OBJECTIVE
  To investigate the impact of the involvement of primary care physicians (PCPs) on the receipt of preventive follow-up care after a breast cancer (BC) diagnosis among a low-income population.
  
  
  METHODS
  Multiple logistic regression analyses were performed to identify potential factors associated with receipt of preventive care among 579 low-income women with BC. The main outcome variables at 36 months after BC diagnosis were receipt of annual mammography, Papanicolaou smear in the past 2 years, and ever had colonoscopy for those who were at least 50 years old. The main independent variable was type of provider visit in the past 12 months.
  
  
  RESULTS
  Women with a PCP visit only or both PCP and surgeon/cancer specialist visits in the past 12 months were more likely to have had annual mammography (adjusted odds ratio [AOR], 2.67; P = .109 and AOR, 2.20, P = .0008, respectively), a Papanicolaou smear in the past 2 years (AOR, 2.90; P = .04 and AOR, 2.24, P = .009, respectively), and colonoscopy (AOR, 2.99; P = .041 and AOR, 2.17; P = .026, respectively) than those who only visited surgeons/cancer specialists. Indeed, women who saw only a PCP for their follow-up care had the highest odds ratio of receiving each clinical care service.
  
  
  CONCLUSIONS
  The involvement of PCPs in the medical care of low-income BC survivors results in better preventive follow-up care. Getting PCPs involved in the care of cancer survivors might be particularly pertinent for low-income populations because of lower costs and ease of access compared with cancer specialist-provided care.
authors.affiliation: the Department of Family Medicine, the Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles; and the Departments of Family Medicine and Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.
authors.forename: Rose C
authors.initials: RC
authors.lastname: Maly
authors.forename: Yihang
authors.initials: Y
authors.lastname: Liu
authors.forename: Allison L
authors.initials: AL
authors.lastname: Diamant
authors.forename: Amardeep
authors.initials: A
authors.lastname: Thind
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002140:California / Q000453:epidemiology; D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000592:standards*; D011314:Preventive Health Services / Q000592:standards*; D011320:Primary Health Care / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D017741:Survivors
keywords: Breast Cancer; Low Income Population; Primary Care Physicians; Quality of Health Care; Women's Health