Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?
By: Wenli Lu1,2,3, Liesbeth Jansen4, Michael Schaapveld5, Peter C Baas6, Theo Wiggers4 and Geertruida H De Bock1

  1. Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands
  2. Department of Health Statistics, School of Public Health, Tianjin Medical University, China
  3. Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, China
  4. Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
  5. Comprehensive Cancer Centre North-Netherlands, The Netherlands
  6. Department of Surgery, Martiniziekenhuis, The Netherlands

BMC Cancer 2011, 11:279 doi:10.1186/1471-2407-11-279

Published: 28 June 2011


Abstract

Background

After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare.

Methods

Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE).

Results

The median follow-up time was 9.0 (0.3-18.1) years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74), patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52) and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25).

Conclusions

Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended.

Keywords

Breast neoplasm; Utilization; Follow-up; Mammography

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