Table 2.
Survey questions and results on encounter with coverage denials
| Always | Most of the time | Some of the time | Neutral/unsure | Never | Service not offered/provided | |
|---|---|---|---|---|---|---|
| Maintenance therapies | ||||||
| Hormone therapy (e.g., tamoxifen and estrogen inhibitor) (n = 115) | 0.00% | 0.87% | 19.13% | 6.96% | 55.65% | 17.39% |
| Maintenance chemotherapy (n = 117) | 0.85% | 1.71% | 37.61% | 8.55% | 30.77% | 20.51% |
| Maintenance immunotherapy (n = 115) | 1.74% | 5.22% | 34.78% | 9.57% | 24.35% | 24.35% |
| Aromatase inhibitors (n = 113) | 1.77% | 1.77% | 17.70% | 7.08% | 53.98% | 17.70% |
| Screening for new primary cancers | ||||||
| Breast cancer | ||||||
| Annual mammogram (n = 98) | 1.02% | 2.04% | 9.18% | 3.06% | 71.43% | 13.27% |
| Annual gynecological assessment in post-menopausal women on SERMs (n = 109) | 0.92% | 2.75% | 13.76% | 14.68% | 46.79% | 21.10% |
| Colorectal cancer | ||||||
| Annual imaging with CT scan (n = 105) | 0.95% | 6.67% | 32.38% | 8.57% | 24.76% | 26.67% |
| Lab work including CEA (n = 107) | 0.00% | 1.87% | 24.30% | 7.48% | 42.06% | 24.30% |
| Gynecologic cancer | ||||||
| Physical examination for endometrial cancer (with full review of symptoms) (n = 100) | 0.00% | 2.00% | 9.00% | 13.00% | 39.00% | 37.00% |
| Testing of CA-125 levels in select patients who had an elevated level before treatment for ovarian cancer (n = 100) | 0.00% | 0.00% | 23.00% | 13.00% | 30.00% | 34.00% |
| CT scans of the chest for patients treated for uterine sarcomas (n = 100) | 1.00% | 3.00% | 26.00% | 17.00% | 17.00% | 36.00% |
| CT scans every 6 months for first 2 years after completion of curative treatment for ovarian cancer (n = 100) | 1.00% | 1.00% | 23.00% | 17.00% | 22.00% | 36.00% |
| Annual CT scan (beginning in year 3) after completion of curative treatment for ovarian cancer (n = 99) | 1.01% | 2.02% | 21.21% | 18.18% | 21.21% | 36.36% |
| Serial pelvic sonography for women who have undergone fertility-preserving surgery with or without tumor markers (n = 99) | 1.01% | 1.01% | 10.10% | 31.31% | 14.14% | 42.42% |
| Head and neck cancers | ||||||
| Routine age and gender appropriate screening (n = 101) | 0.00% | 4.95% | 11.88% | 13.86% | 34.65% | 34.65% |
| Low-dose CT for high risk patients based on smoking history (n = 101) | 0.00% | 6.93% | 33.66% | 9.90% | 20.79% | 28.71% |
| Hodgkin lymphoma | ||||||
| Laboratory studies, as indicated (e.g., CBC, platelets, ESR, and TSH) (n = 105) | 0.00% | 0.95% | 10.48% | 10.48% | 50.48% | 27.62% |
| CT scan with contrast as indicated (n = 104) | 0.00% | 4.81% | 21.15% | 8.65% | 37.50% | 27.88% |
| PET/CT if indicated (n = 104) | 1.92% | 10.58% | 36.54% | 8.65% | 15.38% | 26.92% |
| Lung cancer | ||||||
| Low-dose CT scan (LDCT) (n = 103) | 0.97% | 3.88% | 33.01% | 10.68% | 23.30% | 28.16% |
| Screening for cancer recurrence or late effects of cancer treatment | ||||||
| Breast cancer | ||||||
| 6-month post-treatment mammogram (N = 103) | 0.00% | 3.88% | 22.33% | 6.80% | 47.57% | 19.42% |
| Annual mammogram (N = 103) | 0.00% | 0.00% | 8.74% | 3.88% | 69.90% | 17.48% |
| MRI (patients meeting high risk) (N = 104) | 1.92% | 9.62% | 51.92% | 5.77% | 13.46% | 17.31% |
| Colorectal cancer | ||||||
| Colorectal cancer screening (e.g., colonoscopy) (n = 102) | 0.00% | 0.98% | 17.65% | 12.75% | 37.25% | 31.37% |
| Screening for bladder cancer (for those treated for rectal cancer) (n = 102) | 0.00% | 1.96% | 23.53% | 20.59% | 15.69% | 38.24% |
| CEA testing (n = 100) | 0.00% | 3.00% | 21.00% | 7.00% | 44.00% | 25.00% |
| Annual abdominal and chest imagining with CT scan in first 3-year post-treatment (n = 102) | 1.96% | 3.92% | 25.49% | 9.80% | 33.33% | 25.49% |
| Surveillance colonoscopy (n = 102) | 0.00% | 0.98% | 17.65% | 7.84% | 48.04% | 25.49% |
| Gynecologic cancer | ||||||
| Physical examination for endometrial cancer (with full review of symptoms) (n = 94) | 0.00% | 0.00% | 5.32% | 18.09% | 41.49% | 35.11% |
| Testing of CA-125 levels in select patients who had an elevated level before treatment for ovarian cancer (n = 94) | 0.00% | 3.19% | 17.02% | 14.89% | 29.79% | 35.11% |
| CT scans of the chest for patients treated for uterine sarcomas (n = 94) | 1.06% | 2.13% | 22.34% | 20.21% | 20.21% | 34.04% |
| CT scans every 6 months for first 2 years after completion of curative treatment for ovarian cancer (n = 93) | 1.08% | 2.15% | 19.35% | 18.28% | 24.73% | 34.41% |
| Annual CT scan (beginning in year 3) after completion of curative treatment for ovarian cancer (n = 93) | 1.08% | 3.23% | 19.35% | 16.13% | 24.73% | 35.48% |
| Serial pelvic sonography for women who have undergone fertility-preserving surgery with or without tumor markers (n = 93) | 1.08% | 3.23% | 7.53% | 23.66% | 16.13% | 48.39% |
| Head and neck cancer | ||||||
| Physical examination every 1–3 months in first year post-treatment (n = 96) | 0.00% | 0.00% | 9.38% | 11.46% | 53.13% | 26.04% |
| Physical examination every 2–6 months in second year post-treatment (n = 96) | 0.00% | 2.08% | 5.21% | 12.50% | 55.21% | 25.00% |
| Physical examination every 4–8 months in years 3–5 post-treatment (n = 96) | 0.00% | 1.04% | 9.38% | 16.67% | 47.92% | 25.00% |
| Annual physical exam after 5 years (n = 96) | 0.00% | 2.08% | 6.25% | 16.67% | 48.96% | 26.04% |
| Hodgkin lymphoma | ||||||
| Laboratory studies, as indicated (e.g., CBC, platelets, ESR, and TSH) (n = 101) | 0.00% | 0.99% | 4.95% | 10.89% | 59.41% | 23.76% |
| CT scan with contrast as indicated (n = 101) | 0.00% | 3.96% | 18.81% | 11.88% | 41.58% | 23.76% |
| PET/CT if indicated (n = 102) | 4.90% | 4.90% | 37.25% | 10.78% | 18.63% | 23.53% |
| Stress test/ECHO (n = 100) | 0.00% | 3.00% | 21.00% | 17.00% | 31.00% | 28.00% |
| Carotid ultrasound for those receiving neck radiation (n = 101) | 0.00% | 2.97% | 17.82% | 25.74% | 22.77% | 30.69% |
| Breast MRI in those with prior mantle radiation (n = 99) | 4.04% | 4.04% | 36.36% | 17.17% | 14.14% | 24.24% |
| Lung cancer | ||||||
| Low-does CT screening (n = 99) | 1.01% | 6.06% | 30.30% | 10.10% | 26.26% | 26.26% |
| Prostate cancer | ||||||
| Measure of serum PSA every 6–12 months within first 5 years (n = 98) | 0.00% | 2.04% | 13.27% | 9.18% | 52.04% | 23.47% |
| Annual measure of serum PSA after 5 years (n = 98) | 0.00% | 2.04% | 9.18% | 12.24% | 53.06% | 23.47% |
| Annual DRE (n = 98) | 0.00% | 2.04% | 4.08% | 12.24% | 52.04% | 29.59% |