Abstract 3578: The use of preventive services among prostate cancer survivors

Abstract

Abstract Introduction and Objectives: It is well established that most men diagnosed with prostate cancer die from other causes. However, concerns have been expressed that the diagnosis often focuses subsequent care on prostate-related issues rather than overall health. We sought to determine if the use of general preventive services were diminished in a cohort of men following their diagnosis of prostate cancer. Methods: Using the California Men's Health Study, a prospective cohort study of over 40,000 men ages 45-69 years at baseline in 2002 who were recruited through the Kaiser Permanente Southern California Health Plan, we identified 1636 men who were newly diagnosed with prostate cancer from 2002 through 2008. Preventive services evaluated included 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). The use of preventive services was compared in the two years prior to and following prostate cancer diagnosis using matched odds ratios (MOR) and 95% confidence intervals (CI) adjusted for baseline age, Charlson comorbidity index, education, smoking and income. Results: Of the 1636 men diagnosed with prostate cancer, men were equally as likely to receive a pneumococcal vaccination, a hemoglobin A1c or glucose test for diabetes and screening for colorectal cancer before and after prostate cancer diagnosis (Pneumococcal MOR: 1.00, 95% CI: 0.72-1.37; Hemoglobin A1c MOR: 1.01, 95% CI: 0.51-2.01; Glucose MOR: 1.07, 95% CI: 0.71-1.60; Colorectal cancer screening MOR: 0.91, 95% CI: 0.56-1.47). The adjusted odds of receiving an influenza vaccine were 2.6 times greater after prostate cancer diagnosis when compared to before diagnosis (MOR: 2.62, 95% CI: 1.53-4.49). However, men were approximately 70% less likely to receive a cholesterol test (MOR: 0.30, 95% CI: 0.15-0.59) and HDL test (MOR 0.32, 95% CI: 0.16-0.62) following prostate cancer diagnosis. Also, men were approximately 50% less likely to receive a triglyceride test after diagnosis when compared to before prostate cancer diagnosis (MOR 0.51, 95% CI: 0.29-0.89). Conclusions: Results from this study suggest that once diagnosed with prostate cancer, less attention is paid to preventive care for heart disease. As more men with prostate cancer die from causes other than their cancer, screening for and maintenance of preventable diseases of aging is critical and warrants improvement. This analysis also highlights the importance of transitioning care back to primary care physicians after men have undergone treatment for prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3578. doi:1538-7445.AM2012-3578