DESCRIPTION (provided by applicant): High 5-year relative survival rates for common cancers types such as breast, colorectal and prostate, mean that persons with these cancers should receive recommended preventive services, as well a high quality care for other co-existing chronic diseases. This project will test if recommended clinical preventive services and quality of care guidelines are met as frequently among elderly Americans who develop cancer as among elderly persons without cancer. The services we will study are (a) influenza immunization; (b) the diabetes quality of care measures: annual determination of serum hemoglobin Alc, serum low-density lipids, eye examination, and monitoring for nephropathy; and (c) screening for breast, colorectal and prostate cancer. We will study elderly Medicare fee-for-service beneficiaries identified in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database with incident breast, colorectal or prostate cancer in 1999, or incident breast or prostate cancer in 1996 or 1997. Specifically, we will: 1. Compare the rates of utilization of the recommended care in the newly diagnosed cancer patients in the period after the completion of initial treatment to the rates in a 5% sample of elderly Americans living in SEER areas who do not have cancer; 2. where sufficient statistical power exists, we will compare the use of services in the majority population (non-Hispanic whites) with the minority population groups: non-Hispanic blacks, Hispanics and Asians. In addition, we will do a stratified sub-set analysis of use of these measures among persons who are diagnosed with carcinoma in situ or localized cancer compared with those with regional or distant disease. As a result of this study, providers will know if an increased emphasis needs to be placed on providing these services to all persons with these types of cancer or to certain sub-groups of the population.
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