title: Quality of preventive care before and after prostate cancer diagnosis.
abstract: OBJECTIVE
  To examine if the use of general preventive services were diminished in a cohort of men following their diagnosis of prostate cancer.
  
  
  METHODS
  16,604 men enrolled in Kaiser Permanente Southern California who were newly diagnosed with prostate cancer from January 1, 2002 through December 31, 2009 were passively followed through electronic medical records to determine the use of preventive services, including screening for colorectal cancer (colonoscopy and/or fecal occult blood tests (FOBT)), tests for diabetes (glucose and hemoglobin A1c) and heart disease (serum cholesterol, high density lipoprotein (HDL) and triglycerides) and vaccinations (influenza and pneumococcal). Preventive service use was compared in the two years prior to and following prostate cancer diagnosis using matched odds ratios (MOR) and 95% confidence intervals (CI) in 2013.
  
  
  RESULTS
  Men were more likely to receive a flu vaccine (MOR: 2.70, 95% CI: 2.52-2.90), lipid tests (MOR: 1.51, 95% CI: 1.42-1.61), diabetes tests (MOR: 2.13, 95% CI: 2.00-2.26) and screening for colorectal cancer (MOR: 1.80, 95% CI: 1.71-1.89) in the two years after prostate cancer diagnosis compared to before. Men with advanced disease at diagnosis were more likely to receive all types of preventive services after diagnosis when compared to men with localized disease.
  
  
  CONCLUSIONS
  Once diagnosed with prostate cancer in this setting, no less attention was paid to general preventive care, although there remains room for improvement in pneumococcal vaccination and colon cancer screening rates. The delivery of high-quality continuing care after diagnosis is critical for aging cancer patients.
authors.affiliation: Department of Medicine and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI.
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Wallner
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, US.
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Slezak
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, US.
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Quinn
authors.affiliation: Department of Urology, Southern California Permanente Medical Group, Downey, CA, US.
authors.forename: Ronald K
authors.initials: RK
authors.lastname: Loo
authors.affiliation: Department of Quality and Clinical Analysis, Southern California Permanente Medical Group, Pasadena, CA, US.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Schottinger
authors.affiliation: Department of Health Services and Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA, US.
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, US.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
keywords: oncology; primary care; prostate cancer- clinical