Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey.

OBJECTIVE

To evaluate predictors of receipt of follow-up instructions at completion of cancer treatment among women with breast and gynecologic cancers (cervical, endometrial, ovarian) in the United States, and determine if the factors differ by cancer type.

METHODS

We designed a cross-sectional study using data from the "Cancer Survivorship" module of the 2016 Behavioral Risk Factor Surveillance System (BRFSS). We created logistic regression models to determine characteristics associated with receipt of follow-up care instructions, and stratified by models by cancer type to evaluate differences in factors.

RESULTS

Our sample included 954 (66%) and 492 (34%) women with breast and gynecologic cancers respectively. Even after adjustment, women treated for gynecologic cancer had 63% lower odds [0.37 (0.25-0.55)] of receiving follow-up instructions compared to women with breast cancer. Among breast cancer patients, those with an income <$25,000 per year had lower odds of receiving follow-up instructions [0.53(0.31-0.92)], while patients with high BMI (BMI ≥30 kg/m) had higher odds of receiving follow-up instructions [1.91 (1.15-3.18)]. Among gynecologic cancer patients, those diagnosed 51-75 years had higher odds of receiving follow-up instructions compared to those diagnosed ≤50 years [2.54 (1.13-5.70)].

CONCLUSION

In our study, gynecologic cancer patients less frequently received follow-up instructions compared to breast cancer patients. Receipt of follow-up instructions also differed by demographic and lifestyle factors. The results provide evidence for the need of public health initiatives to increase the frequency of follow-up instructions for gynecologic cancer patients, which can potentially increase the rate of follow-up and improve long-term outcomes.