Title: Ductal carcinoma in situ (DCIS): Posttreatment follow-up care among Latina and non-Latina White women
Country: United States
Age: Adult Only
Care Setting: Outpatient Ambulatory and Primary Care
Clinical Setting: Breast Cancer Screening
Data Level: State
Data Type: Disease Registry
Data Source: Cancer registry
Conclusion: Disparities In Some Minority Groups
Health OutComes Reported: No
Free Text Conclusion: Spanish speaking Latinas less likely to have mammography. Mitigated in all groups by increased PCP contact.
Abstract: BACKGROUND: There is a lack of information about posttreatment care among patients with ductal carcinoma in situ (DCIS). This study compares posttreatment care by ethnicity-language and physician specialty among Latina and White women with DCIS. METHODS: Latina and White women diagnosed with DCIS between 2002 and 2005 identified through the California Cancer Registry completed a telephone survey in 2006. Main outcomes were breast surveillance, lifestyle counseling, and follow-up physician specialty. KEY RESULTS: Of 742 women (396 White, 349 Latinas), most (90 %) had at least one clinical breast exam (CBE). Among women treated with breast-conserving surgery (BCS; N = 503), 76 % had received at least two mammograms. While 92 % of all women had follow-up with a breast specialist, Spanish-speaking Latinas had the lowest specialist follow-up rates (84 %) of all groups. Lifestyle counseling was low with only 53 % discussing exercise, 43 % weight, and 31 % alcohol in relation to their DCIS. In multivariable analysis, Spanish-speaking Latinas with BCS had lower odds of receiving the recommended mammography screening in the year following treatment compared to Whites (OR 0. 5; 95 % CI, 0. 2-0. 9). Regardless of ethnicity-language, seeing both a specialist and primary care physician increased the odds of mammography screening and CBE (OR 1. 6; 95 % CI, 1. 2-2. 3 and OR 1. 9; 95 % CI, 1. 3-2. 8), as well as having discussions about exercise, weight, and alcohol use, compared to seeing a specialist only. CONCLUSIONS: Most women reported appropriate surveillance after DCIS treatment. However, our results suggest less adequate follow-up for Spanish-speaking Latinas, possibly due to language barriers or insurance access. IMPLICATIONS FOR CANCER SURVIVORS: Follow-up with a primary care provider in addition to a breast specialist increases receipt of appropriate follow-up for all women.