Tarsha Jones1, Debra Duquette2, Meghan Underhill3, Chang Ming4, Kari E Mendelsohn-Victor5, Beth Anderson6, Kara J Milliron7, Glenn Copeland8, Nancy K Janz9, Laurel L Northouse5, Sonia M Duffy10, Sofia D Merajver9,11, Maria C Katapodi12,13. 1. Florida Atlantic University Christine E. Lynn College of Nursing, 777 Glades Road, Boca Raton, FL, 33431, USA. 2. Feinberg School of Medicine, Northwestern University, Arkes Family Pavilion Suite 600, 676 N Saint Clair, Chicago, IL, 60611, USA. 3. The Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA. 4. Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. 5. University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA. 6. Michigan Department of Health and Human Services, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA. 7. University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA. 8. Michigan Cancer Surveillance Program, 333 S. Grand Ave., P.O. Box 30195, Lansing, MI, 48909, USA. 9. School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA. 10. Ohio State University College of Nursing, 1585 Neil Ave, Columbus, OH, 43210, USA. 11. School of Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA. 12. Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. maria.katapodi@unibas.ch. 13. University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA. maria.katapodi@unibas.ch.
Abstract
PURPOSE: This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices. METHODS: Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms. RESULTS: Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. CONCLUSIONS: Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs. IMPLICATIONS: Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.
PURPOSE: This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices. METHODS: Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms. RESULTS: Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years ago), the majority (> 85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. CONCLUSIONS: Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs. IMPLICATIONS: Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.
Entities:
Keywords:
Adherence; Clinical breast exam; Mammography; Out-of-pocket-cost; State cancer registry
Authors: Pierre O Chappuis; Maria C Katapodi; Chang Ming; Valeria Viassolo; Nicole Probst-Hensch; Ivo D Dinov Journal: Br J Cancer Date: 2020-06-22 Impact factor: 7.640