Study found Medicare beneficiaries who did were less likely to develop, die from the disease
MONDAY, Sept. 30 (HealthDay News) -- The more often seniors with Medicare coverage visit their primary care physician, the less likely they are to either get colorectal cancer or die from the disease if they do, new research suggests.
Moreover, the investigation also found that the greater the frequency of visits, the less likely such seniors were to die of any cause at all.
"Specifically in terms of colorectal cancer this is very important to know, because that is one of the cancers that is preventable," explained study author Dr. Jeanne Ferrante, an associate professor in the department of family medicine and community health at Rutgers-Robert Wood Johnson Medical School in Somerset, N.J.
"And we found that people who do visit their primary care physician are more likely to get screened for colorectal cancer," she noted. "And those people, in turn, are less likely to get colorectal cancer, as well as less likely to die from it."
Ferrante and her colleagues discuss their findings in the Oct. 1 issue of the Annals of Internal Medicine.
The American Cancer Society recommends that men and women who face an average risk for colorectal cancer begin getting some type of routine screening starting at age 50. That can take the form of a colonoscopy once a decade, or a flexible sigmoidoscopy or virtual CT colonoscopy once ever five years, and may result in polyp removal.
Those at high risk due to a personal or family history of the disease, polyp development and/or inflammatory bowel disease are encouraged to start screening at an earlier age and to repeat the process more frequently.
For the investigation, the authors sifted through U.S. Surveillance, Epidemiology and End Results (SEER) data on nearly 103,000 Medicare patients newly diagnosed with colorectal cancer between 1994 and 2005. Data covering another approximately 27,000 Medicare patients who died of the disease in that timeframe was also included, as was information on more than 62,000 patients who died of any number of causes.
Given that Medicare typically kicks in at age 65 (and that colorectal cancer screening is not advised for people over the age of 85), the average age of those in the study hovered around 76.
A review of Medicare claims paperwork was conducted to identify all primary care visits made during the four- to 27-month period leading up to a cancer diagnosis or death due to colorectal cancer or any other cause.
The result: Patients who had seen a doctor between five and 10 times in the allotted timeframe had a 6 percent lower risk of disease (and a 22 percent lower risk of colorectal cancer death) than those who had never seen their doctor or had visited just once.
All-cause death rates were 21 percent lower the more often a patient saw their doctor.
That said, Ferrante stressed that in the world of cancer risk many different factors are at play, making it impossible to draw a simple cause-and-effect link between primary care doctor visits and a reduced risk for colorectal cancer diagnosis and mortality.
"For example, we found that although we looked at a group of people that had universal care insurance, still more than one quarter had either never visited a primary care doctor or had done so just once in the study period," she noted. "So it could be that the Medicare patients who do go in to see their primary care physician are so-called 'healthy users' to begin with."
"By that we mean people who are by definition more concerned about their health and make an effort to take better care of themselves in general," Ferrante explained. "So, while we do want to emphasize the importance of seeing a primary care physician, the act of going might actually reflect other factors that contribute to a lower cancer risk."
Dr. Robert Schoen, a professor of medicine and epidemiology at the University of Pittsburgh, suggested that the study should be interpreted as "yet another reason to go see your primary care physician."
"This looks at a basic research question," he noted. "What is the benefit of going to a primary care physician? Do routine physicals help? Do blood tests help? What really is of value here?"
"And this study," Schoen said, "clearly points to a big benefit that comes from going to your doctor, by showing this protective association. Now, there are caveats. Yes, we don't know if the people who go are more health-conscious to begin with, and because this is based on observational data we don't actually know what happens during these visits. What did the doctors actually recommend in terms of screenings? But even so, it is logical to presume that the more contact with a primary care physician, the more likely colorectal cancer prevention was discussed and acted on."
For more on colorectal cancer screening, visit the U.S. National Cancer Institute (http://www.cancer.gov/cancertopics/pdq/screening/colorectal/Patient/ ).
SOURCES: Jeanne Ferrante, M.D., M.P.H., associate professor, department of family medicine and community health, Rutgers Robert Wood Johnson Medical School, Somerset, N.J.; Robert Schoen, M.D., M.P.H., professor, medicine and epidemiology, University of Pittsburgh; Oct. 1, 2013, Annals of Internal Medicine