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Preferences for breast cancer survivorship care by rural/urban residence and age at diagnosis

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Abstract

Purpose

Preferences for survivorship care among recently treated breast cancer survivors may vary by rural-urban residence and age, but potential differences have not been examined.

Methods

We conducted a cross-sectional survey of survivorship preferences among women treated for non-metastatic breast cancer 6–24 months prior to recruitment.

Results

We surveyed 203 women (66% response) with American Joint Committee on Cancer Stage I or II breast cancer. Rural residents comprised 36.5% of respondents (82.7% White, non-Hispanic; 52.5% < college education) and 29.6% were ≥ 65 years. More than 95% indicated that checking for recurrence, receiving additional treatment, evaluation of side effects, and identification of late effects were “very important” reasons for follow-up care. The most common topics identified as “very important” for survivorship care discussions were recommendations for healthy behaviors (65.3%), best sources for breast cancer information (65.3%), and effects on family (53.3%) and job (53.8%). Women 65 years and older preferred to discuss follow-up care at the time of diagnosis (p = 0.002), with younger women preferring during (32%) or after treatment (39.1%). Rural survivors were significantly more likely to identify follow-up care reasons not related to the initial breast cancer as “very important” than urban survivors, including screening for other cancers, and examinations or tests for non-cancer diseases (both p = 0.01).

Conclusions

Survivorship care in accordance with national recommendations will likely be accepted by breast cancer survivors. Tailoring breast cancer survivorship care by timing, integration of primary care services, and specific psychosocial topics may best meet the needs of different ages and demographics.

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References

  1. Breast Cancer Facts & Figures. American Cancer Society. https://www.cancer.org/research/cancer-facts-statistics/breast-cancer-facts-figures.html. Accessed 10 Apr 2019

  2. McCabe MS, Bhatia S, Oeffinger KC, Reaman GH, Tyne C, Wollins DS, Hudson MM (2013) American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol Off J Am Soc Clin Oncol 31:631–640

    Article  Google Scholar 

  3. Shockney LD (2015) The evolution of breast cancer navigation and survivorship care. Breast J 21:104–110

    Article  Google Scholar 

  4. Accreditation Committee Clarifications for Standard 3.3 Survivorship Care Plan. https://www.facs.org/publications/newsletters/coc-source/special-source/standard33. Accessed 7 Jul 2016

  5. Klemanski DL, Browning KK, Kue J (2015) Survivorship care plan preferences of cancer survivors and health care providers: a systematic review and quality appraisal of the evidence. J Cancer Surviv:1–16

  6. Smith SL, Singh-Carlson S, Downie L, Payeur N, Wai ES (2011) Survivors of breast cancer: patient perspectives on survivorship care planning. J Cancer Surviv 5:337–344

    Article  Google Scholar 

  7. Weaver KE, Geiger AM, Lu L, Case LD (2013) Rural-urban disparities in health status among US cancer survivors. Cancer 119:1050–1057

    Article  Google Scholar 

  8. Schootman M, Homan S, Weaver KE, Jeffe DB, Yun S (2013) The health and welfare of rural and urban cancer survivors in Missouri. Prev Chronic Dis 10:E152

    Article  Google Scholar 

  9. Sprague BL, Dittus KL, Pace CM, Dulko D, Pollack LA, Hawkins NA, Geller BM (2013) Patient satisfaction with breast and colorectal cancer survivorship care plans. Clin J Oncol Nurs 17:266–272

    Article  Google Scholar 

  10. Singh-Carlson S, Wong F, Martin L, Nguyen SKA (2013) Breast cancer survivorship and South Asian women: understanding about the follow-up care plan and perspectives and preferences for information post treatment. Curr Oncol 20:e63–e79

    CAS  PubMed  PubMed Central  Google Scholar 

  11. DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, Alteri R, Robbins AS, Jemal A (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64:252–271

    Article  Google Scholar 

  12. Beck SL, Towsley GL, Caserta MS, Lindau K, Dudley WN (2009) Symptom experiences and quality of life of rural and urban older adult cancer survivors. Cancer Nurs 32:359–369

    Article  Google Scholar 

  13. Reid-Arndt SA, Cox CR (2010) Does rurality affect quality of life following treatment for breast cancer? J Rural Health 26:402–405

    Article  Google Scholar 

  14. Burris JL, Andrykowski M (2010) Disparities in mental health between rural and nonrural cancer survivors: a preliminary study. Psychooncology 19:637–645

    Article  Google Scholar 

  15. Schultz AA, Winstead-Fry P (2001) Predictors of quality of life in rural patients with cancer. Cancer Nurs 24:12–19

    Article  CAS  Google Scholar 

  16. Blake KD, Moss JL, Gaysynsky A, Srinivasan S, Croyle RT (2017) Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends. Cancer Epidemiol Prev Biomark 26:992–997

    Article  Google Scholar 

  17. Meneses K, Benz R, Azuero A, Jablonski-Jaudon R, McNees P (2015) Multimorbidity and breast cancer. Semin Oncol Nurs 31:163–169

    Article  Google Scholar 

  18. Befort CA (2002) Klemp J (2011) Sequelae of breast cancer and the influence of menopausal status at diagnosis among rural breast cancer survivors. J Women's Health 20:1307–1313

    Article  Google Scholar 

  19. Palmer NRA, Weaver KE, Hauser SP, Lawrence JA, Talton J, Case LD et al (2015) Disparities in barriers to follow-up care between African American and White breast cancer survivors. Support Care Cancer:1–9

  20. Centers for Disease Control (2011) BRFSS-CDC’s Behavioral Risk Factor Surveillance System. http://www.cdc.gov/brfss/. Accessed 26 Mar 2019

  21. WWAMI Rural Health Research Center (2010) Using RUCA data. http://depts.washington.edu/uwruca/ruca-uses.php. Accessed 26 Mar 2019

  22. Pruitt SL, Eberth JM, Morris ES, Grinsfelder DB, Cuate EL. Rural-Urban Differences in Late-Stage Breast Cancer: Do Associations Differ by Rural-Urban Classification System? Tex Public Health J. 2015;67:19–27.

  23. Arora NK, Hamilton AS, Potosky AL, Rowland JH, Aziz NM, Bellizzi KM, Klabunde CN, McLaughlin W, Stevens J (2007) Population-based survivorship research using cancer registries: a study of non-Hodgkin’s lymphoma survivors. J Cancer Surviv 1:49–63

    Article  Google Scholar 

  24. Weaver KE, Aziz NM, Arora NK, Forsythe LP, Hamilton AS, Oakley-Girvan I et al (2014) Follow-up care experiences and perceived quality of care among long-term survivors of breast, prostate, colorectal, and gynecologic cancers. J Oncol Pract 10(4):e231–e239

    Article  Google Scholar 

  25. Rechis R, Beckjford EB, Arvey SR, Reynolds KA, McGoldrick D (2011) The essential elements of surviorship care: a LIVESTRONG brief. http://www.livestrong.org/pdfs/3-0/EssentialElementsBrief. Accessed 13 May 2013

  26. Hewitt ME (2006) National Cancer Policy Board (U.S.), Committee on Cancer Survivorship: Improving Care and Quality of Life. In: From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington, D.C.

    Google Scholar 

  27. Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte S, Warner E, Lyman GH, Ganz PA (2016) American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. CA Cancer J Clin 66:43–73

    Article  Google Scholar 

  28. Mayer DK, Birken SA, Check DK, Chen RC (2015) Summing it up: an integrative review of studies of cancer survivorship care plans (2006-2013). Cancer 121:978–996

    Article  Google Scholar 

  29. Marbach T, Griffie J (2011) Patient preferences concerning treatment plans, survivorship care plans, education, and support services. Oncol Nurs Forum 38:335–342

    Article  Google Scholar 

  30. Oeffinger KC, McCabe MS (2006) Models for delivering survivorship care. J Clin Oncol 24:5117–5124

    Article  Google Scholar 

  31. Weaver KE, Palmer N, Lu L, Case LD, Geiger AM (2013) Rural–urban differences in health behaviors and implications for health status among US cancer survivors. Cancer Causes Control 24:1481–1490

    Article  Google Scholar 

  32. Fan L, Mohile S, Zhang N, Fiscella K, Noyes K. (2012) Self-Reported Cancer Screening Among Elderly Medicare Beneficiaries: A Rural-Urban Comparison. J Rural Health. 2012;28:312–9.

  33. Doescher MP, Jackson JE. Trends in Cervical and Breast Cancer Screening Practices Among Women in Rural and Urban Areas of the United States. J Public Health Manag Pract. 2009;15:200.

  34. Berry-Stoelzle M, Parang K, Daly J. Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors. Health Serv Res Manag Epidemiol. 2019;6:2333392818822914.

  35. Rayman KM, Edwards J, (2010) Rural Primary Care Providers’ Perceptions of Their Role in the Breast Cancer Care Continuum. J Rural Health 26(2):189–195.

  36. Sheikh K, Bullock C (2001) Urban-rural differences in the quality of care for Medicare patients with acute myocardial infarction. Arch Intern Med 161:737–743

    Article  CAS  Google Scholar 

  37. Chan L, Hart LG, Goodman DC (2006) Geographic access to health care for rural Medicare beneficiaries. J Rural Health 22:140–146

    Article  Google Scholar 

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Acknowledgments

We gratefully acknowledge the contributions of Dr. Douglas Case to the study design and analytic plan. Dr. Julia Lawrence contributed to the study while on the faculty at Wake Forest School of Medicine and is currently employed by Novella Clinical. This study was conducted while Dr. Geiger was employed at Wake Forest School of Medicine

Funding

This work was financially supported by the National Institutes of Health [1R21CA155932]. The authors wish to acknowledge the support of the Wake Forest Baptist Comprehensive Cancer Center, supported by the National Cancer Institute’s Cancer Center Support Grant award number P30CA012197. Chandylen Nightingale’s work on this manuscript was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of health (UL1TR001420).

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Authors and Affiliations

  1. Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA

    Kathryn E. Weaver, Chandylen L. Nightingale, Julia A. Lawrence, Jennifer Talton, Sally Hauser & Ann M. Geiger

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  1. Kathryn E. Weaver
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  2. Chandylen L. Nightingale
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  3. Julia A. Lawrence
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  4. Jennifer Talton
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  5. Sally Hauser
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  6. Ann M. Geiger
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Corresponding author

Correspondence to Kathryn E. Weaver.

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The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Wake Forest Health Sciences Institutional Review Board (IRB). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The Wake Forest Health Sciences Institutional Review Board approved the study with a waiver of written informed consent.

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The opinions expressed in this article are the authors’ own and do not reflect the views of the National Cancer Institute, National Institutes of Health, the Department of Health and Human Services, or the United States government.

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Weaver, K.E., Nightingale, C.L., Lawrence, J.A. et al. Preferences for breast cancer survivorship care by rural/urban residence and age at diagnosis. Support Care Cancer 28, 3839–3846 (2020). https://doi.org/10.1007/s00520-019-05134-z

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