Adherence to Cancer Surveillance Guidelines Varies

Variable adherence to recommended and non-recommended testing for breast, CRC survivors

FRIDAY, March 30 (HealthDay News) -- Insured breast cancer survivors have high rates of guideline-recommended recurrence testing and non-recommended metastatic testing, while only about half of colorectal cancer survivors undergo recommended surveillance and two-thirds receive non-recommended metastatic testing, according to a study published online March 20 in Cancer.

To determine how surveillance practices used in four distinct geographic managed care environments compared with surveillance guideline recommendations, Ramzi G. Salloum, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues conducted a study involving 6,205 insured breast cancer and 2,297 colorectal cancer survivors, between 2000 and 2008.

Within 18 months of treatment, the researchers found that 87.2 percent of breast cancer survivors received recommended mammograms and 55.0 percent of colorectal cancer survivors received recommended colon examinations. Significantly higher rates of surveillance were seen for breast cancer survivors between 50 and 65 years of age and significantly lower rates were seen for colon cancer survivors who were 75 years of age or older. Non-recommended metastatic disease testing was performed for 64.7 percent of breast and 73.3 percent of colorectal cancer survivors. Younger age and comorbidities were associated with higher rates of non-recommended metastatic disease testing for both breast and colorectal cancer survivors, and white race was also associated with increased testing for breast cancer survivors.

"Although many cancer survivors appear to be receiving the minimum recommended surveillance care, a large number, regardless of age, are still not receiving minimum care recommendations, whereas others are receiving non-recommended metastatic disease testing as well as recommended care at a greater frequency than what is suggested," the authors write.

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