Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry
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.
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 45 years old, stratified by race (Black vs. White/Other). Multivariate logistic regression models identified predictors of annual CBEs and mammograms.
Among 859 YBCS (n = 340 Black; n = 519 White/Other; mean age = 51.0 ± 5.9; diagnosed 11.0 ± 4.0 years 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.
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.
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.
KeywordsMammography Clinical breast exam Out-of-pocket-cost Adherence State cancer registry
Joan Such Lockhart, PhD, RN, CORLN, AOCN, CNE, ANEF, FAAN, and Sr. Rosemary Donley, PhD, APRN from Duquesne University School of Nursing, 600 Forbes Avenue, Pittsburgh, PA 15282, USA for providing support and guidance to Dr. Tarsha Jones while she completed her doctoral studies at Duquesne University School of Nursing. Jenna McLosky, CGC, Cancer Genomics Program—Michigan Department of Health and Human Services for patient and relative identification, recruitment, and assessment of eligibility.
Centers for Disease Control and Prevention, 5U48DP001901-03, PI: M.C. Katapodi. Robert Wood Johnson Foundation, Nurse Faculty Scholars Award 68039, PI: M.C. Katapodi.
Compliance with ethical standards
Conflict of interest
Tarsha Jones, Debra Duquette, Meghan Underhill, Kari E. Mendelsohn-Victor, Beth Anderson, Chang Ming, Kara J. Milliron, Glenn Copeland, Nancy K. Janz, Laurel L. Northouse, Sonia M. Duffy, Sofia D. Merajver, and Maria C. Katapodi declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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