Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors

Clinical practice guidelines recommend yearly surveillance mammography for breast cancer survivors, yet many women do not receive this service. The objective of this study was to evaluate factors related to long-term surveillance mammography adherence among breast cancer survivors. We conducted a re...

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Veröffentlicht in:Breast cancer research and treatment 2014-02, Vol.143 (3), p.541-550
Hauptverfasser: Wirtz, Heidi S., Boudreau, Denise M., Gralow, Julie R., Barlow, William E., Gray, Shelly, Bowles, Erin J. A., Buist, Diana S. M.
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container_title Breast cancer research and treatment
container_volume 143
creator Wirtz, Heidi S.
Boudreau, Denise M.
Gralow, Julie R.
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Bowles, Erin J. A.
Buist, Diana S. M.
description Clinical practice guidelines recommend yearly surveillance mammography for breast cancer survivors, yet many women do not receive this service. The objective of this study was to evaluate factors related to long-term surveillance mammography adherence among breast cancer survivors. We conducted a retrospective cohort study among women ≥18 years, diagnosed with incident stage I or II breast cancer between 1990 and 2008. We used medical record and administrative health plan data to ascertain covariates and receipt of surveillance mammography for up to 10 years after completing breast cancer treatment. Surveillance included post-diagnosis screening exams among asymptomatic women. We used multivariable repeated measures generalized estimating equation regression models to estimate odds ratios and robust 95 % confidence intervals to examine factors related to the annual receipt of surveillance mammography. The analysis included 3,965 women followed for a median of six surveillance years; 79 % received surveillance mammograms in year 1 but decreased to 63 % in year 10. In multivariable analyses, women, who were
doi_str_mv 10.1007/s10549-013-2816-3
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We used multivariable repeated measures generalized estimating equation regression models to estimate odds ratios and robust 95 % confidence intervals to examine factors related to the annual receipt of surveillance mammography. The analysis included 3,965 women followed for a median of six surveillance years; 79 % received surveillance mammograms in year 1 but decreased to 63 % in year 10. In multivariable analyses, women, who were &lt;40 years or 80+ years of age (compared to 50–59 years), current smokers, had greater comorbidity, were diagnosed more recently, had stage II cancer, or were treated with mastectomy or breast conserving surgery without radiation, were less likely than other women to receive surveillance mammography. Women with outpatient visits during the year to primary care providers, oncologists, or both were more likely to undergo surveillance. In this large cohort study of women diagnosed with early-stage invasive breast cancer, we found that important subgroups of women are at high risk for non-adherence to surveillance recommendations, even among younger breast cancer survivors. 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A.</creatorcontrib><creatorcontrib>Buist, Diana S. M.</creatorcontrib><title>Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Clinical practice guidelines recommend yearly surveillance mammography for breast cancer survivors, yet many women do not receive this service. The objective of this study was to evaluate factors related to long-term surveillance mammography adherence among breast cancer survivors. We conducted a retrospective cohort study among women ≥18 years, diagnosed with incident stage I or II breast cancer between 1990 and 2008. We used medical record and administrative health plan data to ascertain covariates and receipt of surveillance mammography for up to 10 years after completing breast cancer treatment. Surveillance included post-diagnosis screening exams among asymptomatic women. We used multivariable repeated measures generalized estimating equation regression models to estimate odds ratios and robust 95 % confidence intervals to examine factors related to the annual receipt of surveillance mammography. The analysis included 3,965 women followed for a median of six surveillance years; 79 % received surveillance mammograms in year 1 but decreased to 63 % in year 10. In multivariable analyses, women, who were &lt;40 years or 80+ years of age (compared to 50–59 years), current smokers, had greater comorbidity, were diagnosed more recently, had stage II cancer, or were treated with mastectomy or breast conserving surgery without radiation, were less likely than other women to receive surveillance mammography. Women with outpatient visits during the year to primary care providers, oncologists, or both were more likely to undergo surveillance. 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In multivariable analyses, women, who were &lt;40 years or 80+ years of age (compared to 50–59 years), current smokers, had greater comorbidity, were diagnosed more recently, had stage II cancer, or were treated with mastectomy or breast conserving surgery without radiation, were less likely than other women to receive surveillance mammography. Women with outpatient visits during the year to primary care providers, oncologists, or both were more likely to undergo surveillance. In this large cohort study of women diagnosed with early-stage invasive breast cancer, we found that important subgroups of women are at high risk for non-adherence to surveillance recommendations, even among younger breast cancer survivors. 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source MEDLINE; SpringerNature Journals
subjects Adult
Aged
Aged, 80 and over
Analysis
Breast cancer
Breast Neoplasms - epidemiology
Breast Neoplasms - pathology
Cancer research
Cancer survivors
Cancer therapies
Comorbidity
Drug therapy
Epidemiology
Female
Follow-Up Studies
Health aspects
Humans
Lumpectomy
Mammography
Mammography - methods
Mass Screening
Medical records
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Oncology
SEER Program
Survivors
title Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors
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