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Open Access Research article

Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?

Wenli Lu123, Liesbeth Jansen4, Michael Schaapveld5, Peter C Baas6, Theo Wiggers4 and Geertruida H De Bock1*

Author Affiliations

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

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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