Providers of follow-up care in a population-based sample of breast cancer survivors.
To describe which providers provide breast cancer survivorship care, we conducted a longitudinal survey of nonmetastatic breast cancer patients identified by the SEER registries of Los Angeles and Detroit. Multinomial logistic regression examined the adjusted odds of surgeon compared with a medical oncologist follow-up or primary care provider compared with medical oncologist follow-up, adjusting for age, race/ethnicity, insurance, tumor stage, receipt of chemotherapy, endocrine therapy use, and visit to a medical oncologist at the time of diagnosis. Results were weighted to account for sample selection and nonresponse. 844 women had invasive disease and received chemotherapy or endocrine therapy. 65.2 % reported medical oncologists as their main care provider at 4 years, followed by PCP/other physicians (24.3 %) and surgeons (10.5 %). Black women were more likely to receive their follow-up care from surgeons (OR 2.47, 95 % CI 1.16-5.27) or PCP/other physicians (OR 2.62, 95 % CI 1.47-4.65) than medical oncologists. Latinas were more likely to report PCP/other physician follow-up than medical oncologists (OR 2.33, 95 % CI 1.15-4.73). Compared with privately insured women, Medicaid recipients were more likely to report PCP/other physician follow-up (OR 2.52, 95 % CI 1.24-5.15). Women taking endocrine therapy 4 years after diagnosis were less likely to report surgeons or PCP/other physicians as their primary provider of breast cancer follow-up care. Different survivorship care patterns emerge on race/ethnicity and insurance status. Interventions are needed to inform patients and providers on the recommended sources of breast cancer follow-up.
School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI, 48109-5482, USA, cfriese@umich.edu.
Christopher R
CR
Friese
Kathryn A
KA
Martinez
Paul
P
Abrahamse
Ann S
AS
Hamilton
John J
JJ
Graff
Reshma
R
Jagsi
Jennifer J
JJ
Griggs
Sarah T
ST
Hawley
Steven J
SJ
Katz
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008495:Medical Oncology; D008875:Middle Aged; D010820:Physicians; D058007:Physicians, Primary Care; D018426:SEER Program; D013038:Specialization; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States; D000078329:Workforce