Providers of Follow-Up Care in a Population-Based Sample of Breast Cancer Survivors
Published Date:Jan 31 2014
Source:Breast Cancer Res Treat. 144(1):179-184.
Pubmed Central ID:PMC3991008
Funding:R01 CA088370/CA/NCI NIH HHS/United States
K05 CA111340/CA/NCI NIH HHS/United States
R00 NR010750/NR/NINR NIH HHS/United States
R01 CA139014/CA/NCI NIH HHS/United States
U58 DP000807/DP/NCCDPHP CDC HHS/United States
N01PC54404/CA/NCI NIH HHS/United States
N01PC35145/CA/NCI NIH HHS/United States
N01PC35139/CA/NCI NIH HHS/United States
R01 CA109696/CA/NCI NIH HHS/United States
To describe which providers provide breast cancer survivorship care.
Patients and Methods
We conducted a longitudinal survey of non-metastatic breast cancer patients identified by the SEER registries of Los Angeles and Detroit. Multinomial logistic regression examined the adjusted odds of surgeon compared with a medical oncologist follow up or primary care provider compared with medical oncologist follow up, adjusting for age, race/ethnicity, insurance, tumor stage, receipt of chemotherapy, endocrine therapy use, and visit to a medical oncologist at the time of diagnosis. Results were weighted to account for sample selection and non-response.
844 women had invasive disease and received chemotherapy or endocrine therapy. 65.2% reported medical oncologists as their main care provider at four years, followed by PCP/other physicians (24.3%) and surgeons (10.5%). Black women were more likely to receive their follow-up care from surgeons (OR 2.47, 95% CI 1.16–5.27) or PCP/other physicians (OR 2.62, 95% CI 1.47–4.65) than medical oncologists. Latinas were more likely to report PCP/other physician follow up than medical oncologists (OR 2.33, 95% CI 1.15–4.73). Compared with privately-insured women, Medicaid recipients were more likely to report PCP/other physician follow up (OR 2.52, 95% CI 1.24–5.15). Women taking endocrine therapy four years after diagnosis were less likely to report surgeons or PCP/other physicians as their primary provider of breast cancer follow up care.
Different survivorship care patterns based on race/ethnicity and insurance status. Interventions are needed to inform patients and providers on the recommended sources of breast cancer follow up.
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