Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?
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:10.1186/1471-2407-11-279Published: 28 June 2011
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.
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).
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).
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.