Limitations
cancer, cardiovascular disease
CANCER, CARDIOVASCULAR DISEASE, PCP
There are important limitations to our study. Although our abstraction of available PCP records was comprehensive, it is possible that we did not capture all health care utilization. While PCPs were identified directly from study participants, it is possible that some screening and care related to cancer survivorship may have occurred at other sites not indicated by participants and not captured in the record abstraction. It is also conceivable that PCP offices did not receive or save all records from specialist visits or the results of studies ordered by specialists. Nevertheless, in this relatively young adult population who had to be free of serious cardiovascular disease due to the CHIIP study’s eligibility requirements, nearly a one-fourth did see a specialist in the prior 2 years and 4.1% had a documented cardiologist visit. A greater proportion of survivors reported having completed echocardiography (38.9%) in the past 2 years compared with those whose records indicated this (21.5%); however, participants’ responses could have been affected by recall bias, especially when asked about a specific 2-year time frame. Regardless, as PCPs likely manage overall screening cadences and order most tests, the lack of documentation in PCP records was concerning.Our study cohort also comprises a large number of participants who identified as non-Hispanic White and were more likely to have health insurance than the general US population, among whom the proportions of uninsured adults aged 19 to 64 years ranges from 9% to 15%.