Who provides ongoing care to breast cancer survivors and does it make a difference?

Abstract

199 Background: There is a paucity of data regarding who provides ongoing care for breast cancer survivors, and the impact of this on adherence to screening guidelines. The purpose of this study was to define, in a population based cohort, with whom breast cancer survivors receive their ongoing care and the impact of provider choice on quality of care. Methods: Data from the 2005 National Health Interview Survey were queried for provider types and screening adherence in breast cancer survivors. Statistical analyses were performed using SAS and SUDAAN software. Results: 435 breast cancer survivors were surveyed in 2005. Their mean age was 66, and the median age at diagnosis was 57. 284 (60.9%) were more than 5 yrs out from diagnosis. Of respondents, 84.3% reported having a clinical breast exam (CBE) within the past year and 79.8% reported having had a mammogram (MMG) within the past 2 years. 429 (99%) reported whether they had seen a family physician (GP) and/or OBGYN in the preceding 12 months; specific reference to care by oncologist was unavailable. 91.8% of survivors had seen either their GP and/or OBGYN in the last year. No significant differences were seen in provider choice nor adherence to surveillance recommendations based on survivorship period (≥ or < 5 yrs). There was no significant difference in CBE and MMG between survivors who had seen their GP within the preceding 12 months and those who did not, but those who had seen their OBGYN had a significantly higher rate of having had a CBE (92.0% vs. 81.1%, p=0.01) and MMG (90.1% vs. 75.3%, p<0.01) than those who did not. Adherence to screening recommendations was superior for patients who had been seen by multiple providers than those who had not been seen by any. Conclusions: Breast cancer survivors get their follow-up care through a variety of providers, often relying on primary care. A collaborative survivorship plan involving multiple specialties may improve adherence to screening guidelines. [Table: see text]