title: An analysis of the association between cancer-related information seeking and adherence to breast cancer surveillance procedures.
abstract: BACKGROUND
  Breast cancer surveillance is important for women with a known history of breast cancer. However, relatively little is known about the prevalence and determinants of adherence to surveillance procedures, including associations with seeking of cancer-related information from medical and nonmedical sources.
  
  
  METHODS
  We conducted a longitudinal cohort study of breast cancer patients diagnosed in Pennsylvania in 2005. Our main analyses included 352 women who were eligible for surveillance and participated in both baseline (~1 year after cancer diagnosis) and follow-up surveys. Outcomes were self-reported doctor visits and physical examination, mammography, and breast self-examination (BSE) at 1-year follow-up.
  
  
  RESULTS
  Most women underwent two or more physical examinations according to recommended guidelines (85%). For mammography, 56% of women were adherent (one mammogram in a year) while 39% reported possible overuse (two or more mammograms). Approximately 60% of respondents reported regular BSE (≥ 5 times in a year). Controlling for potential confounders, higher levels of cancer-related information seeking from nonmedical sources at baseline was associated with regular BSE (OR, 1.52; 95% CI, 1.01-2.29; P, 0.046). There was no significant association between information-seeking behaviors from medical or nonmedical sources and surveillance with physical examination or mammography.
  
  
  CONCLUSIONS
  Seeking cancer-related information from nonmedical sources is associated with regular BSE, a surveillance behavior that is not consistently recommended by professional organizations.
  
  
  CONCLUSIONS
  Findings from this study will inform clinicians on the contribution of active information seeking toward breast cancer survivors' adherence to different surveillance behaviors.
authors.affiliation: University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, USA. atan@asc.upenn.edu
authors.forename: Andy S L
authors.initials: AS
authors.lastname: Tan
authors.forename: Mihaela
authors.initials: M
authors.lastname: Moldovan-Johnson
authors.forename: Stacy W
authors.initials: SW
authors.lastname: Gray
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hornik
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D016504:Breast Self-Examination / Q000379:methods / Q000706:statistics & numerical data*; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010414:Pennsylvania; D011237:Predictive Value of Tests; D018570:Risk Assessment; D017741:Survivors