Surveillance and beliefs about follow-up care among long-term XXXX survivors: a comparison of primary care and oncology providers.

@entity1 @entity5 @entity0
PURPOSE: Delivery of follow-up care to @entity0 survivors is an important public health issue due to their increasing number and the anticipated shortage of oncology providers. This study evaluated adherence to American Society of Clinical Oncology (ASCO)-recommended surveillance tests in a bi-ethnic cohort of long-term @entity0 survivors. METHODS: @entity1 (n   =   298) in Arizona and Colorado who had previously participated in a population-based study of @entity0 were enrolled into a follow-up survey approximately 6  years post-diagnosis. ASCO-recommended surveillance (mammogram, clinical breast, and physical exam), other non-recommended tests (e.g. @entity5 markers, imaging scans), and @entity1 ' beliefs were compared by provider type using multivariate logistic regression. RESULTS: No significant differences in @entity1 self-report of physical exam or mammography prevalence by provider type was observed after adjustment for covariates. Receipt of surveillance tests not recommended by ASCO was higher among survivors who saw an oncologist ( @entity5 marker tests: OR   =   3.0, 95  % CI 1.5-5.8; and other blood tests: OR   =   2.0, 95  % CI 1.1-3.5) as compared to those who routinely see a primary care physician. These observed differences persisted after adjustment for age, stage, lapse in insurance, education, or ethnicity. CONCLUSIONS: Although overutilization of non-recommended tests was observed among @entity1 who saw an oncologist, the majority of @entity0 survivors received ASCO-recommended surveillance regardless of provider type. IMPLICATIONS FOR CANCER SURVIVORS: Most @entity0 survivors receive recommended surveillance tests, whether their care is managed by a primary care physician or an oncologist, but some @entity1 receive unnecessary testing. @entity1 should talk with their providers about tests recommended based on their past @entity0 .
