University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, USA.
Cancer Epidemiol Biomarkers Prev. 2013 Jan;22(1):167-74. doi: 10.1158/1055-9965.EPI-12-0781. Epub 2012 Nov 1.
Breast cancer surveillance is important for women with a known history of breast cancer. However, relatively little is known about the prevalence and determinants of adherence to surveillance procedures, including associations with seeking of cancer-related information from medical and nonmedical sources.
We conducted a longitudinal cohort study of breast cancer patients diagnosed in Pennsylvania in 2005. Our main analyses included 352 women who were eligible for surveillance and participated in both baseline (~1 year after cancer diagnosis) and follow-up surveys. Outcomes were self-reported doctor visits and physical examination, mammography, and breast self-examination (BSE) at 1-year follow-up.
Most women underwent two or more physical examinations according to recommended guidelines (85%). For mammography, 56% of women were adherent (one mammogram in a year) while 39% reported possible overuse (two or more mammograms). Approximately 60% of respondents reported regular BSE (≥ 5 times in a year). Controlling for potential confounders, higher levels of cancer-related information seeking from nonmedical sources at baseline was associated with regular BSE (OR, 1.52; 95% CI, 1.01-2.29; P, 0.046). There was no significant association between information-seeking behaviors from medical or nonmedical sources and surveillance with physical examination or mammography.
Seeking cancer-related information from nonmedical sources is associated with regular BSE, a surveillance behavior that is not consistently recommended by professional organizations.
Findings from this study will inform clinicians on the contribution of active information seeking toward breast cancer survivors' adherence to different surveillance behaviors.
乳腺癌监测对于有已知乳腺癌病史的女性很重要。然而,对于监测程序的遵守率及其决定因素,包括与从医疗和非医疗来源获取癌症相关信息的关联,人们了解甚少。
我们对 2005 年在宾夕法尼亚州诊断出的乳腺癌患者进行了一项纵向队列研究。我们的主要分析包括 352 名符合监测条件并参加了基线(癌症诊断后约 1 年)和随访调查的女性。结果是在 1 年随访时自我报告的医生就诊和体检、乳房 X 光检查和乳房自我检查(BSE)。
大多数女性根据建议的指南进行了两次或更多次体检(85%)。对于乳房 X 光检查,56%的女性符合规定(一年进行一次乳房 X 光检查),而 39%的女性报告可能过度使用(两年或更多次乳房 X 光检查)。大约 60%的受访者报告定期进行 BSE(每年≥ 5 次)。控制潜在混杂因素后,基线时从非医疗来源获取更多癌症相关信息与定期进行 BSE 相关(OR,1.52;95%CI,1.01-2.29;P,0.046)。从医疗或非医疗来源获取信息的行为与体检或乳房 X 光检查的监测之间没有显著关联。
从非医疗来源获取癌症相关信息与定期进行 BSE 相关,而 BSE 是一种专业组织并未一致推荐的监测行为。
本研究的结果将为临床医生提供信息,了解积极寻求信息对乳腺癌幸存者遵守不同监测行为的影响。