The Open Public Health Journal

ISSN: 1874-9445 ― Volume 12, 2019

Preventive Services Utilization Among Cancer Survivors Compared to Cancer-free Controls

Annemarie Uhlig1, *, Johannes Uhlig2, 3, Arne Strauss1, Lutz Trojan1, Joachim Lotz2, 4, Ali Seif Amir Hosseini2
1 Department of Urology, University Medical Center, University of Göttingen, Göttingen, Germany
2 Department of Interventional and Diagnostic Radiology, University Medical Center, University of Göttingen, Göttingen, Germany
3 Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States of America
4 German CT for Cardiovascular Research, Partnersite Goettingen, Goettingen, Germany



To summarize the current evidence on preventive services utilization in cancer survivors.


A systematic literature review and meta-analysis was conducted in February 2016. Studies were included if they compared the utilization of influenza vaccination, cholesterol/lipid testing, bone densitometry, or blood pressure measurement among survivors of adulthood cancer to cancer-free controls. Random effects meta-analyses were conducted to pool estimates.


Literature search identified 3740 studies of which 10 fulfilled the inclusion criteria. Cancer survivors were significantly more likely to utilize bone densitometry (OR=1.226, 95% CI: 1.114 – 1.350, p<0.001) and influenza vaccination (OR=1.565, 95% CI: 1.176 – 2.082, p=0.002) than cancer-free controls. No statistically significant differences were detected for blood pressure measurement and cholesterol/lipid testing (OR=1.322, 95% CI: 0.812 – 2.151, p=0.261; OR=1.046, 95% CI: 0.96 – 1.139, p=0.304).


Cancer survivors were more likely to receive influenza vaccinations and bone densitometry. Future studies should evaluate underlying mechanisms and whether the utilization of preventive services translates into prolonged survival of cancer survivors.

Implications for Cancer Survivors:

Our meta-analysis demonstrated cancer survivors to be more likely to receive the preventive services such as influenza vaccination and bone densitometry than cancer free controls. Still, these results should be interpreted in the context of suboptimal utilization of preventive services in general, and for cancer survivors in specific. Future research should evaluate the underlying mechanisms and whether utilization of preventive services is associated with overall survival in cancer survivors.

Keywords: Preventive services, Meta-analysis, Cancer survivors, Lipid testing, Influenza vaccination, Bone densitometry.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 11
First Page: 122
Last Page: 133
Publisher Id: TOPHJ-11-122
DOI: 10.2174/1874944501811010122

Article History:

Received Date: 28/12/2017
Revision Received Date: 09/03/2018
Acceptance Date: 12/03/2018
Electronic publication date: 30/03/2018
Collection year: 2018

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© 2018 Uhlig et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence this author at the Department of Urology, University Medical Center, University of Goettingen, Robert-Koch-Strasse 40, 37075 Goettingen, Germany; Tel:0049-551-39-65891; Email:


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