title: Health care utilisation and characteristics of long-term breast cancer survivors: nationwide survey in Denmark.
abstract: OBJECTIVE
  To investigate long-term female breast cancer survivors' (BCS') health care utilisation, health, and employment.
  
  
  METHODS
  An age-stratified random sample of 2000 female breast cancer survivors (BCS) 5-15 years after primary surgery without recurrence was drawn from the Danish Breast Cancer Cooperative Group register. A self-administered questionnaire assessed sociodemography, health care utilisation, employment, and health-related quality of life (HRQOL). Associations with breast cancer treatment were investigated.
  
  
  RESULTS
  Response rate was 79%. Significantly more BCS than the general women population reported health care utilisation (61% versus. 56%; age-standardised risk ratio (SRR): 1.10; 95% confidence interval (CI) 1.05-1.15), but significantly fewer BCS were disability pensioners (15% versus 19%; SRR: 0.77; 95% CI 0.64-0.93). 'Daily activities limited due to sequelae' were reported by 20%, and 'stopped working/changed job due to sequelae' by 11% of BCS. In multiple logistic regression analysis, radiotherapy (odds ratio (OR) 2.54; 95% CI 1.34-4.80) and endocrine therapy (OR 2.48; 95% CI 1.13-5.45, postmenopausal women only) were significantly related to 'stopped working/changed job due to sequelae'. Time since surgery 5-10 years (versus >10 years) was significantly associated with 'daily activities limited due to sequelae' (OR 2.02; CI 1.43-2.84), which, in turn, was significantly related to poorer HRQOL (all p<0.05). Chemotherapy, receptor status, and protocol allocation did not show significant associations in any analyses.
  
  
  CONCLUSIONS
  Significantly more BCS reported health care utilisation. Radiotherapy, shorter time since surgery, and endocrine therapy predicted daily activity and work limitations due to sequelae.
authors.affiliation: Multidisciplinary Pain Centre, University Hospital Rigshospitalet 7612, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. vpeuckmann@ukaachen.de
authors.forename: V
authors.initials: V
authors.lastname: Peuckmann
authors.forename: O
authors.initials: O
authors.lastname: Ekholm
authors.forename: P
authors.initials: P
authors.lastname: Sjøgren
authors.forename: N K
authors.initials: NK
authors.lastname: Rasmussen
authors.forename: P
authors.initials: P
authors.lastname: Christiansen
authors.forename: S
authors.initials: S
authors.lastname: Møller
authors.forename: M
authors.initials: M
authors.lastname: Groenvold
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000534:rehabilitation* / Q000601:surgery; D003718:Denmark; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009043:Motor Activity; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D018582:Sick Leave / Q000706:statistics & numerical data; D017741:Survivors / Q000706:statistics & numerical data*