Cancer causes & control : CCC · 2026
Characterizing primary care in breast cancer survivors after completion of cancer therapy.
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Kay Kendall, Pan Yancen, Li Jessica, Zhang Lan, Torres Vanessa N, Castellon-Lopez Yelba, Tsai Meng-Han, Datta Geetanjali D, Henry Jennifer, Ramin Cody
Аннотация
PURPOSE: Despite the potential for primary care to optimize comorbidity management among breast cancer survivors, engagement with primary care providers (PCPs) remains low. This study comprehensively examined PCP-led care after breast cancer treatment to identify survivors who may benefit from targeted interventions to improve primary care engagement.
METHODS: We identified 1,582 posttreatment breast cancer survivors from the U.S. Behavioral Risk Factor Surveillance System survey. Weighted multivariable-adjusted logistic regression models were used to examine associations of sociodemographic, lifestyle, clinical, and survivorship-related factors with PCP-led care after cancer treatment.
RESULTS: Overall, 72% of survivors reported receiving PCP-led follow-up (64% among those aged < 65 years; 75% among those aged ≥ 65 years), with survivors aged < 65 years having significantly lower odds of PCP-led care than those aged ≥65 years (OR: 0.63, 95% CI: 0.41-0.98). Racial and ethnic differences were also evident with lower odds of receiving primary care among Non-Hispanic (NH)-Black and NH-Asian survivors compared with NH-White survivors (OR: 0.49, 95% CI: 0.24-0.97; OR: 0.33, 95% CI: 0.11-0.97, respectively), with particularly lower odds among younger Hispanic survivors (OR: 0.13, 95% CI: 0.03-0.49). Geographic variation across regions was also observed (South OR: 0.42, 95% CI: 0.25-0.72; West OR: 0.60, 95% CI: 0.37-0.96, compared with Midwest). Survivors with a history of myocardial infarction further had lower odds of PCP-led care (OR: 0.40, 95% CI: 0.20-0.80).
CONCLUSION: Gaps in PCP-led care after breast cancer treatment underscore the importance of improving access and support for PCP-led engagement throughout survivorship. Future studies are needed to examine barriers to PCP-led care among younger survivors, NH-Black and NH-Asian survivors, and those with heart disease, and to characterize region-specific differences in PCP-led care across the U.S.
METHODS: We identified 1,582 posttreatment breast cancer survivors from the U.S. Behavioral Risk Factor Surveillance System survey. Weighted multivariable-adjusted logistic regression models were used to examine associations of sociodemographic, lifestyle, clinical, and survivorship-related factors with PCP-led care after cancer treatment.
RESULTS: Overall, 72% of survivors reported receiving PCP-led follow-up (64% among those aged < 65 years; 75% among those aged ≥ 65 years), with survivors aged < 65 years having significantly lower odds of PCP-led care than those aged ≥65 years (OR: 0.63, 95% CI: 0.41-0.98). Racial and ethnic differences were also evident with lower odds of receiving primary care among Non-Hispanic (NH)-Black and NH-Asian survivors compared with NH-White survivors (OR: 0.49, 95% CI: 0.24-0.97; OR: 0.33, 95% CI: 0.11-0.97, respectively), with particularly lower odds among younger Hispanic survivors (OR: 0.13, 95% CI: 0.03-0.49). Geographic variation across regions was also observed (South OR: 0.42, 95% CI: 0.25-0.72; West OR: 0.60, 95% CI: 0.37-0.96, compared with Midwest). Survivors with a history of myocardial infarction further had lower odds of PCP-led care (OR: 0.40, 95% CI: 0.20-0.80).
CONCLUSION: Gaps in PCP-led care after breast cancer treatment underscore the importance of improving access and support for PCP-led engagement throughout survivorship. Future studies are needed to examine barriers to PCP-led care among younger survivors, NH-Black and NH-Asian survivors, and those with heart disease, and to characterize region-specific differences in PCP-led care across the U.S.