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Hiroko Kunitake MD 1 , Ping Zheng MD MS 2 , Greg Yothers PhD 2 , Stephanie Land PhD 2

Routine Preventive Care and Cancer Surveillance in Long-Term Survivors (LTS) of Colorectal Cancer: Results from NSABP Protocol LTS-01. Hiroko Kunitake MD 1 , Ping Zheng MD MS 2 , Greg Yothers PhD 2 , Stephanie Land PhD 2

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Hiroko Kunitake MD 1 , Ping Zheng MD MS 2 , Greg Yothers PhD 2 , Stephanie Land PhD 2

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  1. Routine Preventive Care and Cancer Surveillance in Long-Term Survivors (LTS) of Colorectal Cancer:Results from NSABP Protocol LTS-01 Hiroko Kunitake MD1, Ping Zheng MD MS2, Greg Yothers PhD2, Stephanie Land PhD2 Louis Fehrenbacher MD3, Jeffrey Giguere MD4, D.LawrenceWickerham MD2 Patricia A. Ganz MD1, Clifford Y. Ko MD MSHS1 1David Geffen School of Medicine at UCLA; 2NSABP Operations and Biostatistics Center, University of Pittsburgh; 3Kaiser Permanente Medical Center, Vallejo, CA 4Cancer Center of the Carolinas

  2. Disclosures • We have no disclosures

  3. Long-Term Survivors • Growing population of Long-Term Survivors (LTS) of Colorectal Cancer • 10% of 11.1 million cancer survivors in US • Little known about LTS use of: • Routine Preventive Care • Cancer Screening • Cancer Surveillance

  4. How do you identify LTS? • Difficulty in gathering consistent LTS study cohort • Previous studies used Cancer Registries • Possibility of gathering study cohort from Colorectal cancer clinical trials

  5. NSABP LTS-01 Study • Recruited LTS patients from five NSABP adjuvant therapy trials • Colon cancer: C-05, C-06, C-07 • Rectal cancer: R-02, R-03 • Aims of LTS-01: Characterize LTS • Quality of Life • Functional Outcomes • Clinical Symptoms • Health Behaviors • Routine Preventive Care • Cancer Screening • Cancer Surveillance

  6. Aims • Characterize LTS-01 Routine Preventive Care • Comparison with non-cancer general population • Determine LTS-01 rates of Cancer Screening • Comparison with non-cancer general population • Evaluate LTS-01 Cancer Surveillance

  7. Methods • LTS-01 Cohort • Recruited from 60 NSABP study sites • Participated in C-05, C-06, C-07, R-02, R-03 • 5+ year survival • Received computer assisted telephone interview (CATI)

  8. Methods NSABP Participating Sites

  9. Methods • LTS-01 Cohort • Recruited from 60 NSABP study sites • Participated in C-05, C-06, C-07, R-02, R-03 • 5+ year survival • Received computer assisted telephone interview (CATI)

  10. Methods Years of Treatment Trial Accrual C-07

  11. Methods • LTS-01 Cohort • Recruited from 60 NSABP study sites • Participated in C-05, C-06, C-07, R-02, R-03 • 5+ year survival • Received computer assisted telephone interview (CATI) • Control non-cancer cohort National Health Interview Survey (NHIS) 2005 • 3:1 case-matched • Matched on age, gender, race, education

  12. Methods Analysis • Routine Preventive Care of LTS-01 and NHIS • Usual Source of Care, ER visits, Flu shot • Cancer Screening of LTS-01 and NHIS • Mammogram, Pap smear, PSA test 3. Cancer Surveillance of LTS-01 patients • Colonoscopy, CEA test, CT scan

  13. Methods Analysis • Comparison of LTS-01 and NHIS samples: Fisher’s Exact Test • Predictors of Receipt of Care: Logistic Regression Models • Routine Preventive Care • Cancer Screening • Cancer Surveillance

  14. LTS-01 Recruitment Results Total eligible patients 2,408 Patients contacted 976 Patients not interested 232 Patients interested 744 Did not complete interview 36 Completed interview 708

  15. LTS-01 Recruitment Results Total eligible patients 2,408 Patients contacted 976 Patients not interested 232 Patients interested 744 Did not complete interview 36 Completed interview 708

  16. LTS-01 Participants • Colon cancer trials Patients • C-05 147 • C-06 180 • C-07 354 • Rectal cancer trials • R-02 15 • R-03 12 Total: 708 patients

  17. LTS-01 Participation Rates

  18. Demographics

  19. Demographics

  20. LTS-01 and NHIS Comorbidities

  21. Health Behaviors

  22. Factors associated with Usual Source of Care

  23. Factors Associated with Flu Shot

  24. Cancer Screening * Women only # Men only

  25. LTS-01 Cancer Surveillance

  26. LTS-01 Cancer Surveillance and Survivorship

  27. Summary • LTS-01 patients • More usual source of care • Higher rates of flu shot • More cancer screening • High rates of cancer surveillance • Highly motivated LTS-01 patients

  28. Limitations • Selective participation of LTS-01 patients • Variation in length of survival among cancer trials • Nationally representative sample of CRC survivors • Ability to link cancer treatment to late effects Strengths

  29. Implications • Clinical trials as a source of long-term survivor information • Further results of LTS-01 patient-reported outcomes to follow

  30. Extra slides

  31. Factors Associated with ER Use

  32. Cancer Screening by Age: Pap smear

  33. Cancer Screening by Age: Mammogram

  34. Cancer Screening by Age: PSA test

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