Quality of Preventive Care Before and After Prostate Cancer Diagnosis
1assistant professor in the Department of Medicine at the University of Michigan and an adjunct investigator at Kaiser Permanente Southern California, USA
2research manager of biostatistics in the Department of Research and Evaluation at Kaiser Permanente Southern California, USA
3research scientist II in the Department of Research and Evaluation at Kaiser Permanente Southern California, USA
4regional chief of Urology at Kaiser Permanente Southern California, USA
5assistant medical director for quality and clinical analysis at Kaiser Permanente Southern California, USA
6professor in the Department of Health Policy and Management at the School of Public Health and Jonsson Comprehensive Cancer Center at University of California, Los Angeles, USA
7senior director of research in the Department of Research and Evaluation at Kaiser Permanente Southern California, USA
DOI: 10.31083/jomh.v11i5.13 Vol.11,Issue 5,October 2015 pp.14-21
Published: 05 October 2015
Objective: To examine whether general preventive services were diminished in a cohort of men after their diagnosis of prostate cancer.
Method: A total of 16,604 men enrolled in Kaiser Permanente Southern California who were newly diagnosed with prostate cancer from January 1, 2002, through December 31, 2009, were passively followed through EMRs to determine the use of preventive services, including screening for colorectal cancer (colonoscopy and/or fecal occult blood tests [FOBT]), tests for diabetes (glucose and hemoglobin A1c), heart disease (serum cholesterol, high-density lipoprotein [HDL], and triglycerides), and vaccinations (influenza and pneumococcal). Preventive service use was compared in the 2 years prior to and following prostate cancer diagnosis, using matched odds ratios (MORs) and 95% confidence intervals (CIs) in 2013.
Results: Men were more likely to receive a flu vaccine (MOR 2.70, 95% CI 2.52–2.90), lipid tests (MOR 1.51, 95% CI 1.42–1.61), diabetes tests (MOR 2.13, 95% CI 2.00–2.26), and screening for colorectal cancer (MOR 1.80, 95% CI 1.71–1.89) in the 2 years after prostate cancer diagnosis, compared to before diagnosis. Men with advanced disease at diagnosis were more likely to receive all types of preventive services after diagnosis, compared to men with localized disease.
Conclusion: Once diagnosed with prostate cancer in this setting, no less attention was paid to general preventive care, although there remains room for improvement in pneumococcal vaccination and colon cancer screening rates. The delivery of high-quality continuing care after diagnosis is critical for aging cancer patients.
men, depression and miscarriage
Lauren Wallner,Jeff M. Slezak,Virginia P. Quinn,Ronald K. Loo,Joanne E. Schottinger,Roshan Bastani,Steven J. Jacobsen. Quality of Preventive Care Before and After Prostate Cancer Diagnosis. Journal of Men's Health. 2015. 11(5);14-21.
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