Routine Preventive Care and Cancer Surveillance in Long-Term Survivors (LTS) of Colorectal Cancer: Results from NSABP Protocol LTS-01

Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: June 18, 2009

Title: Routine Preventive Care and Cancer Surveillance in Long-Term Survivors (LTS) of Colorectal Cancer: Results from NSABP Protocol LTS-01
Reviewer:
Presenter: Hiroko Kunitake, MD
Affiliation: David Geffen School of Medicine at UCLA

Over 11 million cancer survivors currently reside in the United States, and this number is estimated to continue to rise at a rate of approximately 3% each year. Among these is a growing population of long-term survivors of colorectal cancer, representing about 10% of total cancer survivors living in the US. Cancer survivors may be at increased risk for cardiovascular disease, obesity, osteoporosis, and general functional decline when compared to the general population. In addition, general preventive care is equally important. The National Surgical Adjuvant Breast and Bowel Long Term Survivor Project (NSABP-LTS), described here, was designed to understand the use of preventive care, cancer screening and surveillance by long-term survivors of colorectal cancer.

708 survivors completed the telephone interview. These were compared with a control group without cancer diagnoses.There were some differences in the two groups demographically. The survivors were more likely to have graduated high school, be married, and have health insurance, specificallyprivate health insurance.

Survivors were more likely to have a usual source of medical care and more likely to have gotten a flu shot in the last year. This was associated with having health insurance, which is not surprising. The groups had equivalent ER visits. The survivors were more likely to have had cancer screening (Pap testing: 67.3% vs. 54.8%;mammography: 84.4% vs. 70.7%; PSA testing: 84.5% vs. 74.5%, respectively, p < 0.0001 for all comparisons). Rates of colonoscopy were 96.5% in the survivor group versus 74.1% in the control group.

The survivors in this group had all participated in a clinical trial for their cancer therapy. This may make a difference in follow-up care. Previous studies have found that survivors receive poorer preventive care and cancer screening than the general population, but this study found the opposite. Given that only 3% of adults participate in clinical trials, this group may not be a good representation of the general survivor population. But, this may help us take steps to better determine what predicts better compliance with healthcare among survivors.

Also see Interpreting a Cancer Research Study