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Patterns and determinants of receipt of follow-up mammography and/or clinical examination in a cohort of Italian breast cancer survivors

  • Epidemiology
  • Published:
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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.

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Abbreviations

CBE:

Clinical breast examination

DCO:

Death certificate only

CPO:

Centre for Cancer Prevention

ISTAT:

Italian National Statistics Bureau

ICD9_CM:

International classification of diseases, ninth revision, clinical modification

GEE:

Generalized estimating equations

OR:

Odds ratio

CI:

Confidence interval

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Acknowledgments

The authors would like also to acknowledge the scientific support of the Master in Epidemiology of the University of Turin and by the San Paolo Foundation.

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Correspondence to Orietta Giuliani.

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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.

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The authors declare that they have no conflict of interest.

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Giuliani, O., Mancini, S., Puliti, D. et al. Patterns and determinants of receipt of follow-up mammography and/or clinical examination in a cohort of Italian breast cancer survivors. Breast Cancer Res Treat 158, 543–551 (2016). https://doi.org/10.1007/s10549-016-3895-8

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