TY - JOUR
T1 - High rates of cancer screening among dialysis patients seen in primary care a cohort study
AU - Thorsteinsdottir, Bjorg
AU - Hickson, La Tonya J.
AU - Ramar, Priya
AU - Reinalda, Megan
AU - Krueger, Nicholas W.
AU - Crowson, Cynthia S.
AU - Rule, Andrew D.
AU - Takahashi, Paul Y.
AU - Chaudhry, Rajeev
AU - Tulledge-Scheitel, Sidna M.
AU - Tilburt, Jon C.
AU - Williams, Amy W.
AU - Albright, Robert C.
AU - Meier, Sarah K.
AU - Shah, Nilay D.
N1 - Funding Information:
The data reported here have been supplied by the United States Renal Data System (USRDS). This project was supported by a Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery award (B.T., L.J.H.); the Extramural Grant Program (EGP) by Satellite Healthcare (160610), a not-for-profit renal care provider (B.T., L.J.H.); National Institute on Aging grant 1K23AG051679-01A1 (B.T.) and National Institute of Health (NIH) NIDDK grant K23 DK109134 (L.J.H.). Additional support was provided by the National Center for Advancing Translational Sciences (NCATS) grant UL1 TR000135. Study's contents is the sole responsibility of the authors and do not necessarily represent the official views of NIH.
Funding Information:
The data reported here have been supplied by the United States Renal Data System ( USRDS ). This project was supported by a Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery award (B.T., L.J.H.); the Extramural Grant Program (EGP) by Satellite Healthcare ( 160610 ), a not-for-profit renal care provider (B.T., L.J.H.); National Institute on Aging grant 1K23AG051679-01A1 (B.T.) and National Institute of Health (NIH) NIDDK grant K23 DK109134 (L.J.H.). Additional support was provided by the National Center for Advancing Translational Sciences (NCATS) grant UL1 TR000135 . Study's contents is the sole responsibility of the authors and do not necessarily represent the official views of NIH.
Publisher Copyright:
© 2018
PY - 2018/6
Y1 - 2018/6
N2 - Routine preventive cancer screening is not recommended for patients with end-stage renal disease (ESRD)1[Figure presented] due to their limited life expectancy. The current extent of cancer screening in this population is unknown. Primary care (PC) reminder systems or performance incentives may encourage indiscriminate cancer screening. We compared rates of cancer screening in patients with ESRD, with and without PC visits. This is a retrospective cohort study using United States Renal Data System (USRDS) billing data and electronic medical record data. Patients aged ≥18 years starting dialysis from 2001 to 2008, Midwest regional dialysis network were categorized with or without a PC visit (defined as an office visit in family practice, internal medicine, pediatrics, geriatrics or preventive medicine during the first two years of dialysis). Cancer screening was based on Current Procedural Terminology codes in USRDS. We identified 2512 incident dialysis patients (60% men, median age 65y). Cancer screening rates were more frequent among those seen in PC: 38% vs 19% (P = 0.0002), for breast; 18% vs 10% (P = 0.047) for cervical; 13% versus 8% (P = 0.024) for prostate; and 18% vs 9% (P = 0.0002) for colon cancer. Multivariable analyses found that those with PC were more likely to be screened after adjusting for age, sex, and comorbidities. In our practice, cancer screening rates among chronic dialysis patients are lower than those previously reported for our general population (64% for breast cancer). However, a sizeable proportion of our ESRD population does receive cancer screening, especially those still seen in primary care.
AB - Routine preventive cancer screening is not recommended for patients with end-stage renal disease (ESRD)1[Figure presented] due to their limited life expectancy. The current extent of cancer screening in this population is unknown. Primary care (PC) reminder systems or performance incentives may encourage indiscriminate cancer screening. We compared rates of cancer screening in patients with ESRD, with and without PC visits. This is a retrospective cohort study using United States Renal Data System (USRDS) billing data and electronic medical record data. Patients aged ≥18 years starting dialysis from 2001 to 2008, Midwest regional dialysis network were categorized with or without a PC visit (defined as an office visit in family practice, internal medicine, pediatrics, geriatrics or preventive medicine during the first two years of dialysis). Cancer screening was based on Current Procedural Terminology codes in USRDS. We identified 2512 incident dialysis patients (60% men, median age 65y). Cancer screening rates were more frequent among those seen in PC: 38% vs 19% (P = 0.0002), for breast; 18% vs 10% (P = 0.047) for cervical; 13% versus 8% (P = 0.024) for prostate; and 18% vs 9% (P = 0.0002) for colon cancer. Multivariable analyses found that those with PC were more likely to be screened after adjusting for age, sex, and comorbidities. In our practice, cancer screening rates among chronic dialysis patients are lower than those previously reported for our general population (64% for breast cancer). However, a sizeable proportion of our ESRD population does receive cancer screening, especially those still seen in primary care.
KW - Breast cancer screening
KW - Cervical cancer screening
KW - Colon cancer screening
KW - Dialysis
KW - ESRD
KW - Preventive screening
KW - Prostate cancer screening
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U2 - 10.1016/j.pmedr.2018.03.006
DO - 10.1016/j.pmedr.2018.03.006
M3 - Article
AN - SCOPUS:85044110190
SN - 2211-3355
VL - 10
SP - 176
EP - 183
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
ER -