title: Patterns and determinants of receipt of follow-up mammography and/or clinical examination in a cohort of Italian breast cancer survivors.
abstract: Information regarding the use of mammography by breast cancer survivors is limited. This study aimed at evaluating the compliance to surveillance mammography and/or clinical breast examination and the associated factors among patients living in northern Italy. A cancer registry-based cohort of 1304 patients living in the Health Care District of Forlì was followed up for 10 years. Eighty percent of patients had a mammogram and/or clinical breast examination during the first year after treatment. The proportion decreased to 67 % at 10 years of follow-up. Three demographic characteristics were independently associated with lower odds of having an annual mammogram and/or clinical breast examination: age at diagnosis [odds ratio (OR) 0.51, 95 % confidence interval (CI) 0.41-0.63 for patients aged 65-74 years; and OR 0.14, 95 % CI 0.11-0.18, for patients ≥75 years versus patients aged <64 year]; socio-economic status (OR 0.81, 95 % CI 0.65-1.00, for deprived patients versus patients of the reference class); and hospital travel time greater than 30 min (OR 0.44, 95 % CI 0.29-0.68 versus ≤15 min). With respect to clinical and disease characteristics, lower odds were observed for patients treated with mastectomy (OR 0.79, 95 % CI 0.65-0.97), for patients diagnosed with in situ breast cancer (OR 0.68, 95 % CI 0.46-0.99) as well as with stage II + breast cancer (OR 0.77, 95 % CI 0.63-0.94), and for patients with ≥3 Elixhauser comorbidities (OR 0.43, 95 % CI 0.26-0.71). Adherence to follow-up declined over time. Knowledge of associated factors may assist in improving access to care for breast cancer survivors.
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy. orietta.giuliani@irst.emr.it.
authors.forename: Orietta
authors.initials: O
authors.lastname: Giuliani
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mancini
authors.affiliation: Clinical and Descriptive Epidemiology Unit, ISPO-Cancer Prevention and Research Institute, 50134, Florence, Italy.
authors.forename: Donella
authors.initials: D
authors.lastname: Puliti
authors.affiliation: Regional Health and Social Care Agency of Emilia-Romagna, 40127, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Caranci
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ravaioli
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Vattiato
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Palumbo
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Americo
authors.initials: A
authors.lastname: Colamartini
authors.affiliation: Department of Statistics G. Parenti, University of Florence, 50134, Florence, Italy.
authors.forename: Annibale
authors.initials: A
authors.lastname: Biggeri
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Lauro
authors.initials: L
authors.lastname: Bucchi
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.affiliation: Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008327:Mammography / Q000379:methods*; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D010808:Physical Examination / Q000379:methods*; D011159:Population Surveillance / Q000379:methods*; D017741:Survivors
keywords: Breast cancer; Cancer survivors; Clinical breast examination; Mammography