The three years of support provided by this fellowship award would allow for additional education and research activities to foster my transition into an independent cancer health services researcher. While my previous research has focused on upstream factors associated with the risk and detection of prostate cancer, this proposal will facilitate broadening my research program to include understanding the behaviors, outcomes and issues associated with prostate cancer diagnosis and survivorship. The population of prostate cancer survivors continues to grow as a result of effective cancer related treatment and enhanced survival periods making care following prostate cancer diagnosis an increasingly important issue. However, despite the growing need for comprehensive and integrated survivorship care, studies informing this issue are lacking and questions remain regarding the quality. As such, in order to best determine how to improve the quality of care for prostate cancer survivors it is necessary to gain a better understanding as to how health services are utilized following prostate cancer diagnosis. Preventive care is of particular importance for prostate cancer survivors as most men with prostate cancer will not die due to their cancer but rather from other comorbid diseases of aging. Therefore, to further our understanding regarding the care of prostate cancer survivors and identify areas to improve its quality, we propose to employ the resources of Kaiser Permanente Southern California, a multi-ethnic managed care population of 1.6 million men to accomplish the following specific aims: 1) To describe the utilization of preventive health services for other diseases of aging among prostate cancer survivors, 2) To determine whether race, cancer stage and other individual-level factors influence the use of preventive services following prostate cancer diagnosis 3) To determine whether variation exists in the utilization of preventive health services following prostate cancer diagnosis on a geographic, provider and system level. Completion of these aims will help to determine if men receive appropriate preventive services following their prostate cancer diagnosis and identify care practices that can be improved to better deliver comprehensive survivorship care. Findings from this proposal will also serve as a basis for future independent research funding to develop and test targeted interventions to directly improve the quality and coordination of care for prostate cancer survivors.
The population of prostate cancer survivors is rapidly growing;however concerns regarding the quality of their care following cancer diagnosis remain. Because most men with prostate cancer will not die due to their cancer but rather from other diseases of aging, preventive care for these conditions should be part of their continuing care plan. Therefore, the focus of this research project is to describe how prostate cancer survivors utilize preventive services for other diseases of aging and determine whether variation exists in this utilization after prostate cancer diagnosis on a patient, provider and system level. Findings from this study will help to determine if men use appropriate preventive services following their prostate cancer diagnosis, identify care practices that can be improved to better deliver comprehensive prostate cancer survivorship care and provide evidence to inform policies to improve the quality of cancer survivorship care overall.