ArticleBMC health services research2023
Educational differences in healthcare use among survivors after breast, prostate, lung, and colon cancer - a SEQUEL cohort study.
Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 5 citations in OpenAlex.
- Breast cancer recurrence: socioeconomic position and general practice involvement - a nationwide cohort study in Denmark.Scandinavian journal of primary health care · 2026Article
- Individual and combined effects of marital status, household income, and residence on cancer management and survival in primary bone cancer: a SEER-based retrospective cohort study.Translational cancer research · 2026Article
- Health care utilization up to 11 years after diagnosis among patients with a hematologic malignancy and its association with socioeconomic position.Journal of cancer survivorship : research and practice · 2026Article
- Self-reported health, function, and use of health care services in older prostate cancer survivors compared to matched controls: a cross-sectional study.Journal of cancer survivorship : research and practice · 2026Article
- The mediating role of new morbidities on social inequality in mortality after curative cancer treatment - a SEQUEL study.British journal of cancer · 2025Article
- Who uses self-management apps from the OncoAppstore: description of characteristics, symptoms, and functioning of a real-world user population.Journal of cancer survivorship : research and practice · 2025Article
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Authors and funding
19 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundMany cancer survivors experience late effects after cancer. Comorbidity, health literacy, late effects, and help-seeking behavior may affect healthcare use and may differ among socioeconomic groups. We examined healthcare use among cancer survivors, compared with cancer-free individuals, and investigated educational differences in healthcare use among cancer survivors.
methodsA Danish cohort of 127,472 breast, prostate, lung, and colon cancer survivors from the national cancer databases, and 637,258 age- and sex-matched cancer-free individuals was established. Date of entry was 12 months after diagnosis/index date (for cancer-free individuals). Follow-up ended at death, emigration, new primary cancer, December 31st, 2018, or up to 10 years. Information about education and healthcare use, defined as the number of consultations with general practitioner (GP), private practicing specialists (PPS), hospital, and acute healthcare contacts 1-9 years after diagnosis/index date, was extracted from national registers. We used Poisson regression models to compare healthcare use between cancer survivors and cancer-free individuals, and to investigate the association between education and healthcare use among cancer survivors.
resultsCancer survivors had more GP, hospital, and acute healthcare contacts than cancer-free individuals, while the use of PPS were alike. One-to-four-year survivors with short compared to long education had more GP consultations (breast, rate ratios (RR) = 1.28, 95% CI = 1.25-1.30; prostate, RR = 1.14, 95% CI = 1.10-1.18; lung, RR = 1.18, 95% CI = 1.13-1.23; and colon cancer, RR = 1.17, 95% CI = 1.13-1.22) and acute contacts (breast, RR = 1.35, 95% CI = 1.26-1.45; prostate, RR = 1.26, 95% CI = 1.15-1.38; lung, RR = 1.24, 95% CI = 1.16-1.33; and colon cancer, RR = 1.35, 95% CI = 1.14-1.60), even after adjusting for comorbidity. One-to-four-year survivors with short compared to long education had less consultations with PPS, while no association was observed for hospital contacts.
conclusionCancer survivors used more healthcare than cancer-free individuals. Cancer survivors with short education had more GP and acute healthcare contacts than survivors with long education. To optimize healthcare use after cancer, we need to better understand survivors' healthcare-seeking behaviors and their specific needs, especially among survivors with short education.
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