Increased health care utilization among long-term cancer survivors compared to the average Dutch population: a population-based study.

Abstract

In the present study, self-reported health care utilization of cancer survivors is compared with those of an age- and gender-matched normative population and predictors of health care utilization are identified. A population-based, cross-sectional survey among 1893 long-term survivors of endometrial and prostate cancer and malignant lymphomas (Hodgkin's and non-Hodgkin's) diagnosed between 1989 and 1998 was conducted using the cancer registry of the Comprehensive Cancer Centre South. Cancer survivors visited their general practitioner somewhat more often compared to the age and gender-matched general Dutch population but this effect was not always statistically significant. In addition, they visited their medical specialist significantly more often. Survivors only sporadically (0-3%) visited or required a dietician, sexologist, oncology nurse, pastor, creative therapy or recovery program. Contact with a psychologist, physiotherapist and other cancer survivors took place somewhat more often. Patients visited a medical specialist less often if they were diagnosed with endometrial cancer (OR = 0.2; 95% CI = 0.1-0.5), if they were diagnosed between 10-15 years ago (OR = 0.6; 95% CI = 0.1-0.5) and if they were not married or divorced (OR = 0.5; 95% CI = 0.3-0.9). Contact with a psychologist was related to having a university or college degree (OR = 3.6; 95% CI = 1.3-9.4). Cancer survivors visited their specialist more often compared to the normative population. Changes in health care, such as less administrative work for the specialist and more efficiency, are probably necessary in order to cope adequately with the increasing demand on the system.