Follow-up care for breast cancer survivors
Menée aux Etats-Unis à partir de données portant sur 25 035 patientes ayant survécu à un cancer du sein diagnostiqué entre 2006 et 2014 et traité par chirurgie, cette étude analyse le respect des recommandations concernant les visites médicales de suivi dédié à l'après-cancer (durée médiane de suivi : 3 ans)
Breast cancer survivorship guidelines recommend at least annual follow-up visits, yet the degree to which this occurs in clinical practice is uncertain. Claims data from a U.S. commercial insurance database (OptumLabs) were used to identify women treated with curative intent surgery for newly diagnosed breast cancer between 2006 and 2014. In 25,035 women, median follow-up was 3 years. In the second year after surgery, 9.6% of the patients did not visit a primary care provider, an oncologist, or a surgeon (“guideline-nonadherent”). The guideline-nonadherent proportion increased from 7.8% in women diagnosed in 2006 to 12.2% in those diagnosed in 2014 (two-sided Wald p < 0.001). During years 2-6, guideline-nonadherence was also associated with older age, non-white race, no radiation, no chemotherapy, no endocrine therapy, and increasing time after surgery. There is a substantial and increasing rate of inadequate follow-up among breast cancer survivors. This has the potential to impair outcomes.