Utilization and quality of preventive health care among adult cancer survivors

Project number: 
15-071
Approval date: 
Monday, July 27, 2015
Principal Investigator: 
Lee-Ying,Richard
Institution: 
BC Cancer
Funding Agency: 
Not Available
Datasets requested: 
Hospital Separations (BC Ministry of Health)
bc cancer-external
Deaths (BC Vital Statistics Agency)
PharmaCare (BC Ministry of Health)
Consolidation file (BC Ministry of Health)
bc cancer
Home and Community Care (BC Ministry of Health)
Medical Services Plan (BC Ministry of Health)
PharmaNet
Mental Health (BC Ministry of Health)
Research objective: 

It is estimated that there are over 500,000 adult Canadians living with a personal history of cancer and this is expected to continue to grow. Given the improved outcomes and prognosis for patients diagnosed with cancer, concerns have been raised regarding the quality of medical care that cancer survivors receive. Preventable medical conditions such as cardiovascular disease have become a common and major threat to the life of adult cancer survivors. The utilization and quality of preventive health care in the Canadian cancer survivorship population is unknown.

Aim 1: To characterize the utilization and quality of preventive health care for PRIMARY disease prevention among cancer survivors

i) To measure and compare the temporal trends in the receipt of primary preventive health services, including influenza vaccination, cholesterol testing, bone densitometry, and screening for other cancers (colorectal, cervical), in breast cancer survivors vs matched non-cancer controls.
Hypothesis: Compared to non-cancer controls, breast cancer survivors are less likely to receive primary preventive health care, even after adjusting for various clinical factors.

ii) To measure and compare the temporal trends in the receipt of primary preventive health services, including influenza vaccination, cholesterol testing, bone densitometry, and screening for other cancers (breast, cervical), in colorectal cancer survivors vs matched non-cancer controls.
Hypothesis: Compared to non-cancer controls, colorectal cancer survivors are less likely to receive primary preventive health care, even after adjusting for various clinical factors.

iii) To identify patient, provider, disease and treatment-related factors that may influence the receipt of primary preventive health care in cancer survivors.
Hypothesis: Patient-related factors, such as age, co-morbidities or cancer site, and physician-related factors, such as type of specialty, are associated with the receipt of primary preventive health care among cancer survivors.

Aim 2: To characterize the utilization and quality of health care for the SECONDARY prevention of specific co-morbidities among cancer survivors

i) To measure and compare the temporal trends in the use of and adherence to interventions (preventive medications, cardiac procedures) for the secondary prevention of myocardial infarction in cancer survivors vs matched non-cancer controls.
Hypothesis: Compared to non-cancer controls, cancer survivors are less likely to use and adhere to interventions for the secondary prevention of myocardial infarction, even after adjusting for various clinical factors

ii) To measure and compare the temporal trends in the use of and adherence to interventions (preventive medications, cardiac procedures) for the secondary prevention of heart failure in cancer survivors vs matched non-cancer controls.
Hypothesis: Compared to non-cancer controls, cancer survivors are less likely to use and adhere to interventions for the secondary prevention of heart failure, even after adjusting for various clinical factors

iii) To identify patient, provider, disease and treatment-related factors that may influence the use of and adherence to secondary preventive health measures in cancer survivors.
Hypothesis: Patient-related factors, such as age, co-morbidities or cancer site, and physician-related factors, such as type of specialty, are associated with the use of and adherence to secondary preventive health measures in cancer survivors.


Page last revised: December 5, 2017