title: Preventive care receipt and office visit use among breast and colorectal cancer survivors relative to age- and gender-matched cancer-free controls.
abstract: OBJECTIVE
  We compare breast and colorectal cancer survivors' annual receipt of preventive care and office visits to that of age- and gender-matched cancer-free controls.
  
  
  METHODS
  Automated data, including tumor registries, were used to identify insured individuals aged 50+ at the time of breast or colorectal cancer diagnosis between 2000 and 2008 as well as cancer-free controls receiving care from four integrated delivery systems. Those with metastatic or un-staged disease, or a prior cancer diagnosis were excluded. Annual visits to primary care, oncology, and surgery as well as receipt of mammography, colorectal cancer, Papanicolaou, bone densitometry, and cholesterol screening were observed for 5 years. We used generalized estimating equations that accounted for repeated observations over time per person to test annual service use differences by cancer survivor/cancer-free control status and whether survivor/cancer-free status associations were moderated by patient age <65 years and calendar year of diagnosis.
  
  
  RESULTS
  A total of 3743 breast and 1530 colorectal cancer survivors were identified, representing 12,923 and 5103 patient-years of follow-up, respectively. Compared to cancer-free controls, breast and colorectal cancer survivors were equally or more likely to use all types of office visits and to receive cancer screenings and bone densitometry testing. Both breast and colorectal cancer survivors were less likely than cancer-free controls to receive cholesterol testing, regardless of age, year of diagnosis, or use of primary care.
  
  
  CONCLUSIONS
  Programs targeting cancer survivors may benefit from addressing a broad range of primary preventive care needs, including recommended cardiovascular disease screening.
authors.affiliation: Department of Social and Behavioral Health and Massey Cancer Center, School of Medicine, Virginia Commonwealth University, PO Box 980149, Richmond, VA, 23298, USA, jelstonlafat@vcu.edu.
authors.forename: Jennifer Elston
authors.initials: JE
authors.lastname: Lafata
authors.forename: Ramzi G
authors.initials: RG
authors.lastname: Salloum
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fishman
authors.forename: Debra Pearson
authors.initials: DP
authors.lastname: Ritzwoller
authors.forename: Maureen C
authors.initials: MC
authors.lastname: O'Keeffe-Rosetti
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000534:rehabilitation; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000534:rehabilitation; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D018426:SEER Program; D055502:Secondary Prevention; D012737:Sex Factors; D017741:Survivors