Table 1.
Unadjusted and adjusted odds ratios (cancer compared with control) of meeting quality measures
| Quality measure | Cohort | |||||||
|---|---|---|---|---|---|---|---|---|
| Combined | Breast cancer | Colorectal cancer | Prostate cancer | |||||
| Unadjusteda | Adjustedb | Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Blood pressure ≤ 150/90 mmHg | ||||||||
| Odds ratioc | 1.02 | 1.05 | 0.96 | 1.00 | 0.96 | 0.96 | 1.14 | 1.16* |
| 95% CI | (0.93–1.13) | (0.96–1.16) | (0.81–1.14) | (0.85–1.18) | (0.81–1.14) | (0.81–1.13) | (0.97–1.13) | (1.00–1.35) |
| Blood pressure ≤ 140/80 mmHg | ||||||||
| Odds ratio | 1.02 | 1.04 | 1.00 | 1.06 | 1.00 | 0.99 | 1.04 | 1.06 |
| 95% CI | (0.94–1.10) | (0.97–1.12) | (0.87–1.15) | (0.93–1.20) | (0.88–1.14) | (0.87–1.11) | (0.92–1.18) | (0.95–1.19) |
| Total cholesterol ≤ 5 mmol/L | ||||||||
| Odds ratio | 0.81***† | 0.82***† | 0.95 | 1.03 | 0.85 | 0.80**† | 0.66***† | 0.66***† |
| 95% CI | (0.73–0.89) | (0.75–0.90) | (0.80–1.15) | (0.88–1.21) | (0.72–1.01) | (0.68–0.93) | (0.57–0.77) | (0.57–0.76) |
| Albumin creatinine ratio test | ||||||||
| Odds ratio | 0.81***† | 0.83***† | 0.78**† | 0.80** | 0.81* | 0.81* | 0.84* | 0.86 |
| 95% CI | (0.73–0.89) | (0.75–0.91) | (0.65–0.92) | (0.68–0.95 | 0.67–0.97) | (0.68–0.97) | (0.72–0.99) | (0.73–1.01) |
| ACE-I or ARBd | ||||||||
| Odds ratio | 0.64 | 0.48 | 0.85 | 0.57↑ | 0.81 | 0.76↑ | 0.44 | 0.33↑ |
| 95% CI | (0.30–1.35) | (0.21–1.10) | (0.13–5.75) | (0.05–5.98) | (0.26–2.60) | (0.23–2.56) | (0.14–1.43) | (0.09–1.14) |
| HbA1c ≤ 59 mmol/mol | ||||||||
| Odds ratio | 0.80***† | 0.77***† | 0.74** | 0.72***† | 0.79* | 0.80*↑ | 0.86 | 0.79**† |
| 95% CI | (0.72–0.89) | (0.70–0.85) | (0.60–0.90) | (0.61–0.85) | (0.65–0.97) | (0.68–0.95) | (0.72–1.02) | (0.68–0.92) |
| HbA1c ≤ 64 mmol/mol | ||||||||
| Odds ratio | 0.78***† | 0.75***† | 0.76**† | 0.74***† | 0.76** | 0.77**† | 0.80* | 0.73**† |
| 95% CI | (0.70–0.87) | (0.68–0.82) | (0.62–0.93) | (0.63–0.88) | (0.63–0.93) | (0.65–0.91) | (0.67–0.95) | (0.63–0.85) |
| HbA1c ≤ 75 mmol/mol | ||||||||
| Odds ratio | 0.81***† | 0.80***† | 0.86 | 0.86 | 0.74** | 0.76** | 0.83* | 0.79**† |
| 95% CI | (0.73–0.91) | (0.73–0.89) | (0.70–1.05) | (0.72–1.03) | (0.60–0.90) | (0.63–0.91) | (0.70–1.00) | (0.67–0.93) |
| Influenza immunization | ||||||||
| Odds ratio | 1.26* | 1.31**†↑ | 0.93 | 0.95↑ | 0.98 | 0.96↑ | 2.04***† | 2.18***† |
| 95% CI | (1.03–1.53) | (1.07–1.59) | (0.66–1.31) | (0.68–1.34) | (0.69–1.39) | (0.67–1.36) | (1.46–2.86) | (1.56–3.06) |
| Retinal screening | ||||||||
| Odds ratio | 0.96 | 0.99 | 1.01 | 1.03 | 1.00 | 1.03 | 0.89 | 0.91 |
| 95% CI | (0.88–1.05) | (0.91–1.08) | (0.87–1.18) | (0.88–1.19) | (0.85–1.18) | (0.88–1.20) | (0.77–1.03) | (0.79–1.05) |
| Foot exam | ||||||||
| Odds ratio | 0.79**† | 0.94 | 0.75* | 0.88 | 0.76* | 0.92 | 0.93 | 1.03 |
| 95% CI | (0.68–0.92) | (0.85–1.04) | (0.57–0.98) | (0.74–1.04) | (0.58–0.99) | (0.78–1.09) | (0.71–1.21) | (0.87–1.21) |
| Dietary review | ||||||||
| Odds ratio | 0.85 | 1.01 | 0.77 | 0.89 | 0.87 | 1.02 | 0.98 | 1.08 |
| 95% CI | (0.70–1.03) | (0.87–1.16) | (0.53–1.13) | (0.66–1.21) | (0.66–1.14) | (0.80–1.28) | (0.69–1.39) | (0.83–1.41) |
| Asked about erectile dysfunction | ||||||||
| Odds ratio | 0.94 | 1.06 | NA | NA | 0.86 | 1.00 | 1.02 | 1.08 |
| 95% CI | (0.77–1.16) | (0.89–1.26) | NA | NA | (0.64–1.15) | (0.75–1.32) | (0.78–1.34) | (0.86–1.35) |
| Advice about erectile dysfunction | ||||||||
| Odds ratio | 1.55* | 1.60** | NA | NA | 1.17 | 1.26 | 1.68** | 1.71**† |
| 95% CI | (1.09–2.19) | (1.18–2.18) | NA | NA | (0.65–2.11) | (0.71–2.26) | (1.14–2.48) | (1.21–2.41) |
ACE-I angiotensin-converting enzyme inhibitor, ARB angiotensin receptor blocker, HbA1c glycosylated hemoglobin, NA not applicable
*p < 0.05, **p < 0.01, ***p < 0.001
†Remained statistically significant after Benjamini-Hochberg adjustment for multiple comparisons
↑Goodness of fit of the model was significantly improved by adding an interaction term for time versus cancer, and interaction term indicates effect of cancer over time was to increase the adjusted odds of the outcome measure in the cancer group
aThe multilevel logistic regression models for the unadjusted odds ratios also included time (years) as a factor variable and a random effect for the patient
bThe regression models for the adjusted odds ratios also included age, sex (combined cohorts, colorectal cancer), year of index date, smoking status, drinking status, body mass index, Charlson Comorbidity Index, Index of Multiple Deprivation score, baseline blood pressure, baseline total cholesterol, baseline HbA1c, history of one or more microvascular complications of diabetes, history of one or more macrovascular complications of diabetes, and history of diabetes medications
cOdds ratios: cancer compared to control
dIn patients diagnosed with nephropathy or microalbuminuria