Determinants of follow-up care utilization among young breast cancer survivors: Results from a nationwide study

The number of breast cancer survivors is increasing. With the longer survival period, comprehensive follow-up care is necessary. The aim of this study is to explore the determinants of survivorship care among breast cancer survivors, including the socioeconomic and healthcare-related factors.We built a retrospective cohort study starting 366 days post-diagnosis. Stage I-III breast cancer women younger than 50 year-old, diagnosed from 2004 to 2007 were included (n=9847). Using the national health insurance database, cancer registry data and death registry data, we examined the survivorship care utilization, including surveillance (i.e. breast ultrasound and mammography) and preventive care (i.e. cholesterol screening, cardiac ultrasound, abdominal ultrasound), in the survivorship year 1 (days 366 to 730 postdiagnosis). We evaluated trends over time using the Cochran–Armitage trend test. Multivariable logistic regression models were used to identify determinants.A significant increasing trend (p< .0001) in follow-up care was observed between 2004 and 2007. The majority of survivors (81%) were followed by both oncology specialists and primary care providers (PCPs). Breast cancer survivors, who were younger, diagnosed at earlier stages, more comorbidities, higher socioeconomic status, living in urban areas, treated in medical centers and public hospitals, and who were followed by both specialists and PCPs, may have better chance to receive appropriate follow-up care.