Characterizing primary care in breast cancer survivors after completion of cancer therapy.

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.