Study finds cancer survivors do not always have best access to primary care

While cancer survivors require follow-up care to prevent a recurrence of their cancer and to watch for after effects of treatment, they also need the same preventive check-ups suggested for all people.

A new study in the American Journal of Preventive Medicine finds that cancer survivors between the ages of 18 and 64 do not always have the best access to primary care and that the type of health insurance they have—or don't have—may be a factor.

"We looked at aspects of primary care that are recommended for everyone: flu vaccines, blood pressure and cholesterol check-ups, dental visits," said Robin Yabroff, Ph.D., MBA, the lead researcher of the study. "Among individuals ages 18-64 with private health insurance, cancer survivors were more likely to have a usual source of care and receive preventive services than individuals without a cancer history. Among those who were uninsured or had public insurance, cancer survivors were generally less likely."

Dr. Yabroff noted that one way to look at it was to evaluate the frequency of dental visits.

"Among individuals ages 18-64 with private insurance, about 73 percent of those who have been diagnosed with cancer reported dental visits in the past year as opposed to 69 percent of those who were not cancer survivors," said Dr. Yabroff.

For those with public insurance, 37 percent of cancer survivors reported visiting a dentist while 49 percent without a cancer history did. Among the uninsured, 31 percent of cancer survivors reported visits while 37 of those without a cancer history did.

As the U.S. population ages and more people are diagnosed with and survive cancer, preventive care for cancer survivors will become a bigger issue.

"Unfortunately, second cancers are not uncommon, especially after radiation therapy," said Emily S. Tonorezos, M.D., MPH, a general internist at Sloan-Kettering Cancer Center's Adult Long-Term Follow Up Program. "Adequate follow-up care is essential for the early detection and successful treatment of second cancers."

According to Dr. Yabroff, the subject requires additional research, particularly in relation to the implementation of the Affordable Care Act, which will expand health insurance coverage.

"We need to look at coordination of care among primary care providers and oncologists to make sure cancer survivors are getting the care they need," said Dr. Yabroff.

Dr. Torenzos recommended that patients and their oncologists make a cancer treatment summary and survivorship care plan.

"This document should detail cancer diagnosis, treatment, and required follow-up including screening and surveillance," said Dr. Torenzos. "The cancer treatment team should provide this type of document, or something similar, to patients who complete therapy."