Jones 2018
Year: 2018
Title: Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry
Country: United States
Age: Adult Only
Sex: Female
Population: Black
Care Setting: Outpatient Ambulatory and Primary Care
Clinical Setting: Breast Cancer Screening
Data Level: State
Data Type: Disease Registry
Data Source: State cancer registry
Conclusion: Disparities In All Minority Groups
Health OutComes Reported: No
Mitigation: No
Free Text Conclusion: Black cancer survivors less likely to report screening mammography although trend less in controlled model.
Abstract: Purpose: This study examined clinical breast exam (CBE) and mammography surveillance in long-term young breast cancer survivors (YBCS) and identified barriers and facilitators to cancer surveillance practices. Methods: Data collected with a self-administered survey from a statewide, randomly selected sample of YBCS diagnosed with invasive breast cancer or ductal carcinoma in situ younger than 45years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms. Results: Among 859 YBCS (n=340 Black; n=519 White/Other; mean age= 51.0 5.9; diagnosed 11.0 4.0years ago), the majority (>85%) reported an annual CBE and a mammogram. Black YBCS in the study were more likely to report lower rates of annual mammography and more barriers accessing care compared to White/Other YBCS. Having a routine source of care, confidence to use healthcare services, perceived expectations from family members and healthcare providers to engage in cancer surveillance, and motivation to comply with these expectations were significant predictors of having annual CBEs and annual mammograms. Cost-related lack of access to care was a significant barrier to annual mammograms. Conclusions: Routine source of post-treatment care facilitated breast cancer surveillance above national average rates. Persistent disparities regarding access to mammography surveillance were identified for Black YBCS, primarily due to lack of access to routine source of care and high out-of-pocket costs. Implications: Public health action targeting cancer surveillance in YBCS should ensure routine source of post-treatment care and address cost-related barriers. Clinical Trials Registration Number: NCT01612338.