title: Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?
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.
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Wenli
authors.initials: W
authors.lastname: Lu
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Jansen
authors.forename: Michael
authors.initials: M
authors.lastname: Schaapveld
authors.forename: Peter C
authors.initials: PC
authors.lastname: Baas
authors.forename: Theo
authors.initials: T
authors.lastname: Wiggers
authors.forename: Geertruida H
authors.initials: GH
authors.lastname: De Bock
mesh_terms: D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000534:rehabilitation* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D016555:Matched-Pair Analysis; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance; D017410:Practice Guidelines as Topic
chemical_list: D018931:Antineoplastic Agents, Hormonal