Colorectal cancer survivors’ surveillance patterns and experiences of care: A SEER-CAHPS study.

Authors

null

Michelle A Mollica

National Cancer Institute, Bethesda, MD

Michelle A Mollica , Lindsey Enewold , Lisa M Lines , Michael T. Halpern , Jessica R. Schumacher , Ron D. Hays , James Todd Gibson , Nicola C. Schussler , Erin E. Kent

Organizations

National Cancer Institute, Bethesda, MD, RTI International, Waltham, MA, Temple University College of Public Health, Philadelphia, PA, Department of Surgery, University of Wisconsin, Madison, WI, University of California, Los Angeles, Los Angeles, CA, Information Management Services, Washington, DC, Information Management Services, Inc., Calverton, MD

Research Funding

NIH

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer, generally treated with surgical resection, followed by complex surveillance for recurrence. We examined associations between experiences of care and adherence to surveillance Medicare fee-for-service beneficiaries with a history of CRC. Methods: Using linked data from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) cancer registry program, Medicare claims and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience surveys (SEER-CAHPS), we identified survivors ages 65+, diagnosed with local/regional first primary colorectal cancer 1999-2009 who underwent surgical resection and completed CAHPS survey within 36 months of diagnosis. Adherence to guidelines for a three-year observation period was defined as receiving a colonoscopy; at least 2 carcinoembryonic antigen (CEA) tests; and more than 2 office visits and 1 computer tomography (CT) imaging test each year. We dichotomized CAHPS ratings into 9 or 10 out of 10 versus 0-9 for analysis (higher ratings mean better quality). Results: Most of the 314 participants reported ratings of 9 or 10 for overall care (55%), personal doctor (59%), and health plan (60%). Slightly less than half (47%) gave their specialist doctor ratings of 9 or 10. Adherence to surveillance was 76% for office visits, 36.9% for CEA testing, 48.1% for colonoscopy, and 10.3% for CT Imaging. Sixty-two percent of the sample were categorized as adherent (receiving ≥ 2 surveillance guidelines). In multivariable models, adherence to office visits was positively associated with ratings of personal doctor (OR = 2.0; 95% CI = 1.1, 3.5) and specialist doctor (OR = 2.7; 95% CI = 1.4, 4.9), and overall adherence was associated with ratings of personal doctor (OR = 2.1; 95% CI = 1.2, 3.6). Conclusions: Findings point to the important role of patient-provider relationships in adherence to CRC post-resection surveillance guidelines. As adherence to surveillance may increase survival among CRC survivors, further investigation is needed to identify specific components of this relationship, as well as other potential modifiable drivers of surveillance guidelines.

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Abstract Details

Meeting

2017 Cancer Survivorship Symposium

Session Type

Poster Session

Session Title

Poster Session B: Late- and Long-term Effects/Comorbidities, Psychosocial Issues, and Recurrence and Secondary Malignancies

Track

Late- and Long-term Effects/Comorbidities,Psychosocial Issues,Recurrence and Secondary Malignancies

Sub Track

Detection of Recurrence and Secondary Malignancies

Citation

J Clin Oncol 35, 2017 (suppl 5S; abstr 229)

DOI

10.1200/JCO.2017.35.5_suppl.229

Abstract #

229

Poster Bd #

K12

Abstract Disclosures

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