Routine Surveillance Care After Cancer Treatment With Curative Intent

BACKGROUND: Many consensus guidelines recommend routine surveillance to detect recurrent disease among cancer survivors. We compare surveillance care receipt to guideline recommendations. METHODS: Cohorts of patients aged 30 years or older diagnosed with breast, colorectal, endometrial, lung, or prostate cancer between 1990 and 1995 and treated with curative intent were identified (n = 100 per site). Receipt and indications for examinations and procedures were abstracted from medical records for as long as 5 years after treatment. Kaplan-Meier product estimates were used to estimate time to initial and subsequent service receipt. RESULTS: Most cancer patients received the recommended minimum number of physical examinations after treatment. In fact, a sizable number of cancer survivors received physical examinations at a frequency in excess of what is currently recommended. Similarly, most of these cancer survivors received recommended testing for local recurrence. Yet, less than two thirds of colorectal cancer patients received recommended colon examinations in the initial year after treatment. Among colorectal, lung, and prostate cancer patients who received recommended initial local recurrence testing, repeat testing tended to occur more frequently than what is currently recommended. The use of testing for metastatic disease that is not recommended in guidelines is also commonplace among these cancer survivors. CONCLUSIONS: Among cohorts of cancer patients, we found wide variation in the use of surveillance care, including patterns of care receipt reflective of both underuse and overuse relative to guideline recommendations. Clinical reasons for these variations and the cost and health implications deserve further study

Breast cancer · Cancer · Cancer registry · Colorectal cancer · Disease · Family medicine · Guideline · Intensive care medicine · Lung cancer · Medical record · Pathology · Physical therapy · Prostate cancer · Receipt · Cancer survivorship and care · Colorectal Cancer Treatments and Studies · Emergency Medicine · Global Cancer Incidence and Screening · Internal Medicine · Medicine

• Use of Guideline Recommended Follow-Up Care in Cancer Survivors

  Gregory S Cooper, Christine Cole Johnson et al.•Medical Care•2006

  Incluir item

• Health Insurance and Other Factors Associated With Mammography Surveillance Among Breast Cancer Survivors

  Susan A Sabatino, Trevor D Thompson et al.•Medical Care•2012

  Incluir item

• The Utility of Administrative Data for Measuring Adherence to Cancer Surveillance Care Guidelines

  Gregory S Cooper, Lonni Schultz et al.•Medical Care•2007

  Incluir item

• The use of mammography by survivors of breast cancer

  M Robyn Andersen, Nicole Urban•American Journal of Public Health•1998

  Incluir item

• Underutilization of Mammography in Older Breast Cancer Survivors

  Marilyn M Schapira, Timothy L Mcauliffe et al.•Medical Care•2000

  Incluir item

• Sociodemographic Differences in the Receipt of Colorectal Cancer Surveillance Care Following Treatment With Curative Intent

  Jennifer Elston Lafata, Christine Cole Johnson et al.•Medical Care•2001

  Incluir item