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Disparities
For Cancer Survivors, Worse Care
John O'nell, The New York Times
September 21, 2004
People who survive cancer appear to get worse care than the general population when it comes to other diseases, a study released last week concluded.
According to the study, published in the online version of the journal Cancer, the number of cancer survivors, which is over eight million in the United States today, is increasing as treatments improve.
The study focused on a group of about 14,000 Medicare patients who had been treated for colon cancer, which is regarded as highly curable in its early stages. Their care over the course of two years after cancer treatment was compared with that of 14,000 Medicare patients who had never had cancer.
The study's lead author, Dr. Craig C. Earle of the Dana Farber Cancer Institute in Boston, said the review showed that the cancer patients were less likely to receive a number of preventive measures or adequate follow-up care for other conditions.
"Monitoring cholesterol, especially in patients with heart disease, and diabetes follow-up are two areas that seem to consistently fall through the cracks a bit," Dr. Earle said.
The cancer patients were also treated less aggressively for heart failure.
The gaps were larger for patients who were older, black or poor, and smallest for patients who continued to see both an oncologist and a primary care physician.
Dr. Earle said the disparities could reflect a tendency to focus exclusively on the threat of cancer recurrence, a sense of fatalism on the part of patients or confusion about whether an oncologist overseeing cancer aftercare was handling a patient's other needs as well.
"We need to do a better job of making sure that the patients we cure of cancer don't lose track of their other physicians," Dr. Earle said.
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