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

Support Care Cancer. 2020 Aug;28(8):3839-3846. doi: 10.1007/s00520-019-05134-z. Epub 2019 Dec 13.

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.

Keywords: Breast cancer; Follow-up care; Geriatrics; Psychosocial; Rural; Survivorship.

MeSH terms

  • Age Factors
  • Aged
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / psychology
  • Cancer Survivors / psychology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Rural Population
  • Surveys and Questionnaires
  • Survivorship
  • Urban Population