Other Illnesses Ignored in Cancer Survivors

Previous Cancers May Shift Attention From Other Common Medical Issues

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Sept. 13, 2004 -- Cancer survivors may not receive the care they need to protect themselves from complications arising from other common medical problems, such as heart disease and diabetes.

A new study shows that people who survive cancer are less likely to receive recommended screening tests and care for other diseases and health issues than those who never had cancer. Researchers say the findings show that a history of cancer may shift the attention of both patients and health care providers away from other potentially deadly threats.

The number of cancer survivors has grown to more than 9.6 million in recent years and is expected to continue to rise, thanks in part to improved treatments for the disease.

Researchers say most people diagnosed with cancer today will not die from it, which means preventive care and treatment of other medical conditions is also important for cancer survivors.

Cancer Survivors Undertreated for Other Illnesses

In the study, published in the Sept. 13 online edition of the journal Cancer, researchers compared Medicare claims from more than 14,000 colon cancer survivors with those from a similarly matched group of people who never had cancer.

Researchers found that colorectal cancer survivors were less likely than healthy people to receive the recommended care for managing their other medical conditions.

For example, of 63% of cancer survivors with heart disease (stable angina, or chest pain upon exertion) had their cholesterol levels checked regularly by their health care provider compared with 69% of noncancer survivors.

Cancer survivors with diabetes were also less likely to have regular follow-up visits and annual vision exams.

In addition, the study showed that cancer survivors were less likely to receive recommended preventive care, such as:

Female cancer survivors were also less likely to receive cervical cancer screening and bone density testing to screen for osteoporosis.

Researchers say cancer survivors who were followed by both a primary care physician and an oncologist (cancer doctor) were more likely to receive the recommended care; those followed by only an oncologist were least likely to get adequate noncancer care.

"Having a prior cancer diagnosis may shift attention away from important noncancer problems," write researcher Craig Earle, MD, of the Dana-Farber Cancer Institute in Boston, and colleagues. "In addition, cancer survivors may use specialists as their personal physicians, yet these providers may not always be aware that they are expected to provide increasingly complex primary care."

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SOURCE: Earle, C. Cancer, Sept. 13, 2004 online edition; vol 101.
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