Quality cancer-survivorship care: Receipt of guideline-recommended cardiovascular disease (CVD) preventive care among healthy cancer survivors in the United States.

Abstract

108 Background: Improving cancer survivorship care is a high priority research area. CVD is a major cause of mortality in cancer survivors. Preventive care reduces CVD mortality and is part of guideline recommended care for all individuals. We examined receipt of CVD preventive measures among healthy cancer survivors compared to the non-cancer population using the National Health Interview Survey (NHIS). Methods: NHIS is a population-based, annual survey designed to provide data representative of the health care received by the U.S. population. For this analysis, 1,860 survivors without CVD risk factors (hypertension, diabetes, or hyperlipidemia) were matched to 7,393 controls without CVD risk factors based on age, race, gender, and survey year. Multivariate logistic regression models examined factors associated with receipt of each preventive measure. Results: Cancer survivors were more likely than controls to visit a general doctor and a specialist during the past year (Table). Further, survivors were more likely to have received CVD preventive care (blood pressure and cholesterol check) and undergone behavior modification (tobacco cessation and exercise). Survivors > 5 years versus < 2 years from diagnosis were no better in CVD preventive measures, except slightly higher rate of exercise (51 vs. 48%, p < 0.001). On multivariate analysis, general doctor visitation was associated with receipt of blood pressure check (OR 7.0), cholesterol check (OR 2.9), smoking cessation attempt (OR 1.4) and exercise (OR 1.3); survivors vs. control were no different in CVD preventive care. Conclusions: Care by a general doctor improves receipt of CVD preventive measures for cancer survivors and non-cancer individuals alike. This study supports the integral involvement of primary care physicians in a “shared care model” for the delivery of quality cancer survivorship care. [Table: see text]