Do cancer survivors follow screening guidelines better?

Abstract

1597 Background: The Institute of Medicine emphasized the need for survivorship care plans which elucidate screening guidelines for cancer survivors. Few data exist regarding whether a personal history of cancer is associated with better adherence to cancer screening guidelines. We sought to determine whether cancer survivors had better adherence to colorectal, prostate, cervical and breast cancer screening guidelines. Methods: The 2005 National Health Interview Survey (NHIS), including the Cancer supplement issued that year which included data regarding cancer screening practices, was queried. The NHIS is a population-based, face-to-face survey administered by the Centers for Disease Control designed to be representative of the US population. Results: Of the 31,428 people surveyed, 2428 (7.34%) had a previous history of cancer. 5,698 people over the age of 40 (96.89%) had a colorectal screening examination (colonoscopy, sigmoidoscopy, or proctoscopy) in the past 10 years. A past history of cancer (61.34% vs. 40.45%, p<0.001), and specifically colorectal cancer (84.47% vs. 42.95%, p<0.001), significantly influenced the receipt of colorectal screening. 14,659 women over the age of 21 (88.24%) had a PAP smear within the past 3 years. A past history of cancer was associated with a significantly lower rate of PAP smears (81.03% vs. 88.92%, p<0.001); a past history of cervical cancer did not affect receipt of PAP smears (88.29% vs. 88.24%, p==0.984). 2350 men over the age of 40 (42.57%) reported having a PSA test within the past year. A past history of cancer (61.36% vs. 39.26%, p<0.001) and specifically prostate cancer (85.41% vs. 40.48%, p<0.001) were associated with a significantly higher rate of PSA testing. 7061 women over the age of 40 (65.51%) had a mammogram within the past 2 years. A past history of cancer (74.53% vs. 64.34%, p<0.001), and specifically breast cancer (80.06% vs. 64.96%. p<0.001), were associated with a significantly higher rate of mammography. Conclusions: It may be intuitive that cancer survivors would be more diligent in following cancer screening guidelines, but this is not uniformly the case. Survivorship care plans, and other tools, geared towards improving cancer surveillance in the survivorship period are required.