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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Study Objectives and Specific Aims: This study's objective is to ensure that elderly cancer patients receive the highest quality care for their non-cancer conditions in conjunction with their cancer care, thereby improving their quality of life and maximizing their survival. Most elderly cancer patients enter the cancer care system with a broad range of medical conditions. Little information is available on cancer patients' receipt of non-cancer care. The specific aims of this study are: 1) to compare the receipt of non-cancer care (recommended preventive care, care for chronic medical conditions, and elective surgical procedures) among colorectal cancer patients compared to an age/sex matched non-cancer cohort, 2) to compare receipt of noncancer care among colorectal cancer patients before and after their cancer diagnosis, 3) to identify the patient, tumor, physician/health system, and environmental factors associated with non-cancer care use among colorectal cancer patients, 4) to determine whether receipt of recommended preventive or chronic disease care is associated with improved overall survival among colorectal cancer patients, and 5) to identify the physician specialties providing the most care to colorectal cancer patients. Research Design and Methods: This study will use a retrospective cohort design to evaluate receipt of non-cancer care among colorectal cancer patients and non-cancer controls. This secondary database analysis will use Surveillance, Epidemiology, and End Results (SEER) program data on stage I-III colorectal cancer patients diagnosed between 1992 and 1999 linked with 1991-2001 Medicare claims data and the American Medical Association Master file. Data for controls will be provided by the 1991-2001 Medicare claims for the 5 percent sample of Medicare beneficiaries living in the SEER areas. We first will define preventive, chronic disease, and elective surgical care measures using claims data, then compare non-cancer care both before and after cancer diagnosis, as well as between the cancer and non-cancer cohorts. We will use logistic regression analyses to identify the factors associated with receipt of non-cancer care, and survival analysis to determine whether there is an association between receipt of preventive and diabetic care services and survival.