Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain.
European Higher Education Area Doctoral Program in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain.
J Cancer Surviv. 2022 Feb;16(1):132-141. doi: 10.1007/s11764-021-01011-z. Epub 2021 Mar 23.
This study aimed to evaluate health service utilization in Spain among long-term breast cancer survivors and to compare it with that among women with no history of breast cancer.
Study based on the SURBCAN cohort includes a sample of long-term breast cancer survivors and a sample of women without breast cancer from 5 Spanish regions. Healthcare utilization was assessed through primary care, hospital visits, and tests during the follow-up period (2012 to 2016) by using electronic health records. Annual contact rates to healthcare services were calculated, and crude and multivariate count models were fitted to estimate the adjusted relative risk of healthcare services use.
Data were obtained from 19,328 women, including 6512 long-term breast cancer survivors. Healthcare use was higher among breast cancer survivors (20.9 vs 16.6; p < 0.0001) and decreased from >10 years of survival. Breast cancer survivors who underwent a mastectomy were more likely to have a primary care visit (RR = 3.10 95% CI 3.08-3.11). Five to ten years survivors were more likely to have hospital inpatient visits and imaging test compared to women without breast cancer (RRa = 1.35 95% CI 1.30-1.39 and RRa = 1.27 95% CI 1.25-1.29 respectively).
This study shows higher use of health services in long-term breast cancer survivors than in women without breast cancer regardless of survival time.
These results help to estimate the health resources needed for the growing group of breast cancer survivors and to identify risk factors that drive higher use of health services.
本研究旨在评估西班牙长期乳腺癌幸存者的卫生服务利用情况，并将其与无乳腺癌史女性进行比较。
本研究基于 SURBCAN 队列，纳入了来自西班牙 5 个地区的长期乳腺癌幸存者和无乳腺癌女性样本。通过电子健康记录，在随访期间（2012 年至 2016 年）评估医疗保健利用情况，包括初级保健、医院就诊和检查。计算每年与医疗保健服务的接触率，并拟合粗计数模型和多变量计数模型，以估计医疗保健服务使用的调整后相对风险。
共纳入 19328 名女性，其中 6512 名为长期乳腺癌幸存者。乳腺癌幸存者的医疗保健利用率较高（20.9 次 vs 16.6 次；p<0.0001），且随着生存时间的延长而降低。接受乳房切除术的乳腺癌幸存者更有可能进行初级保健就诊（RR=3.10 95%CI 3.08-3.11）。与无乳腺癌女性相比，5 至 10 年幸存者更有可能进行住院和影像学检查（RRa=1.35 95%CI 1.30-1.39 和 RRa=1.27 95%CI 1.25-1.29）。
本研究表明，无论生存时间如何，长期乳腺癌幸存者的卫生服务利用率均高于无乳腺癌女性。
这些结果有助于估计不断增长的乳腺癌幸存者群体所需的卫生资源，并确定导致更高卫生服务利用率的风险因素。
