Physician visits and preventive care among Asian American and Pacific Islander long-term survivors of colorectal cancer, USA, 1996-2006

J Cancer Surviv. 2014 Mar;8(1):70-9. doi: 10.1007/s11764-013-0319-1. Epub 2013 Nov 5.

Abstract

Purpose: Published literature on receipt of preventive healthcare services among Asian American and Pacific Islander (API) cancer survivors is scarce. We describe patterns in receipt of preventive services among API long-term colorectal cancer (CRC) survivors.

Methods: Surveillance, Epidemiology, and End Results registry-Medicare data were used to identify 9,737 API and white patients who were diagnosed with CRC during 1996-2000 and who survived 5 or more years beyond their diagnoses. We examined receipt of vaccines, mammography (females), bone densitometry (females), and cholesterol screening among the survivors and how the physician specialties they visited for follow-up care correlated to services received.

Results: APIs were less likely than whites to receive mammography (52.0 vs. 69.3 %, respectively; P < 0.0001) but more likely to receive influenza vaccine, cholesterol screening, and bone densitometry. These findings remained significant in our multivariable model, except for receipt of bone densitometry. APIs visited PCPs only and both PCPs and oncologists more frequently than whites (P < 0.0001). Women who visited both PCPs and oncologists compared with PCPs only were more likely to receive mammography (odds ratio = 1.40; 95 % confidence interval, 1.05-1.86).

Conclusions: Visits to both PCPs and oncologists were associated with increased use of mammography. Although API survivors visited these specialties more frequently than white survivors, API women may need culturally appropriate outreach to increase their use of this test.

Implications for cancer survivors: Long-term cancer survivors need to be aware of recommended preventive healthcare services, as well as who will manage their primary care and cancer surveillance follow-up.

MeSH terms

  • Adenocarcinoma / psychology*
  • Aged
  • Aged, 80 and over
  • Asian Americans / psychology
  • Asian Americans / statistics & numerical data*
  • Bone Density
  • China / ethnology
  • Cholesterol / blood
  • Colorectal Neoplasms / psychology*
  • Early Detection of Cancer / statistics & numerical data
  • European Continental Ancestry Group / psychology
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Georgia / epidemiology
  • Humans
  • Male
  • Mammography / statistics & numerical data
  • Medicine
  • Middle Aged
  • Oceanic Ancestry Group / psychology
  • Oceanic Ancestry Group / statistics & numerical data*
  • Office Visits / statistics & numerical data*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Poverty
  • Preventive Health Services / statistics & numerical data*
  • SEER Program
  • Survivors / psychology
  • Survivors / statistics & numerical data*
  • Vaccination / statistics & numerical data

Substances

  • Cholesterol