Community-based patient navigation and preventative care among women surviving breast cancer.

1602 Background: Routine physical exams, mammograms, and Pap smears are essential to long-term follow-up for breast cancer survivors, enabling detection of recurrence and guiding overall health maintenance. Barriers to preventive care adherence over time can be addressed by community-based organizations (CBOs) by providing information and supportive services, including navigation to screening. We studied adherence to preventive care and screening among breast cancer survivors who engaged a national cancer control CBO–examining how sociodemographics, cancer care factors, and quality of life (QoL) were associated with adherence. Methods: A secondary data analysis was conducted among N = 777 breast cancer survivors who contacted a CBO for resources, including no-cost patient navigation. Patient-reported outcomes were assessed after 30 days, along with survivorship care planning (SCP) and QoL. An index score was created based upon women’s self-reported adherence to receiving routine physical exams, mammograms, and Pap smears at recommended intervals. Results: Among survivors, 37% were age < = 46, 19% were non-white, 63% were in a partnered relationship, 23% rated their QoL (general health) as fair/poor, and 47% carried a pathogenic variant in BRCA . Medical providers caring for these survivors included primary care physicians (53.6%) and oncology specialists (46.4%). For index scores, 66% were adherent to all 3 recommendations for follow-up, 29% to 2 recommendations, and 6% to < = 1 recommendation. The most adhered to recommendation was a physical exam (97%), and the least was a Pap smear (73%): 88% of survivors reported mammograms at recommended intervals. At the bivariate level, breast cancer survivors who were younger (t, df = 4.59, 711, p < .001), non-white, (t, df = -3.27, 267, p < .001), in a partnered relationship (t, df = 1.76, 54, p < .05), and with better QoL (r = -.09 p < .01) were more adherent to guideline-based care. A trend was observed for SCP: survivors who received care summaries (56%), including follow-up instructions (64%), and in written form (45%), were more likely to adhere (r = 0.05, p < .10). In a multivariable regression model adjusting for partnership status and SCP, younger survivors (B = 1.13, p < .001), who were non-white (B = 1.0, p < .01), and with better QoL (B = .09, p < .05) were more adherent. Conclusions: Survivors can benefit from guideline-based cancer prevention and screening with CBO-led support. Tailored SCP is essential to reinforce life-saving health behaviors and enhance follow-up adherence.

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Publication Details

Journal
Journal of Clinical Oncology
Published
2025-05-28
DOI
https://doi.org/10.1200/jco.2025.43.16_suppl.1602
Primary Topic
Global Cancer Incidence and Screening
Type
article
Field-Weighted Citation Impact
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article

Community-based patient navigation and preventative care among women surviving breast cancer.

Marcelo M. Sleiman, Adina Fleischmann, D. Liu, Kenneth P. Tercyak et al.
Journal of Clinical Oncology
Global Cancer Incidence and Screening
article

Community-based patient navigation and preventative care among women surviving breast cancer.

Marcelo M. Sleiman, Adina Fleischmann, D. Liu, Kenneth P. Tercyak, Muriel R. Statman, Anthony J. Zisa
article en

Abstract

1602 Background: Routine physical exams, mammograms, and Pap smears are essential to long-term follow-up for breast cancer survivors, enabling detection of recurrence and guiding overall health maintenance. Barriers to preventive care adherence over time can be addressed by community-based organizations (CBOs) by providing information and supportive services, including navigation to screening. We studied adherence to preventive care and screening among breast cancer survivors who engaged a national cancer control CBO–examining how sociodemographics, cancer care factors, and quality of life (QoL) were associated with adherence. Methods: A secondary data analysis was conducted among N = 777 breast cancer survivors who contacted a CBO for resources, including no-cost patient navigation. Patient-reported outcomes were assessed after 30 days, along with survivorship care planning (SCP) and QoL. An index score was created based upon women’s self-reported adherence to receiving routine physical exams, mammograms, and Pap smears at recommended intervals. Results: Among survivors, 37% were age < = 46, 19% were non-white, 63% were in a partnered relationship, 23% rated their QoL (general health) as fair/poor, and 47% carried a pathogenic variant in BRCA . Medical providers caring for these survivors included primary care physicians (53.6%) and oncology specialists (46.4%). For index scores, 66% were adherent to all 3 recommendations for follow-up, 29% to 2 recommendations, and 6% to < = 1 recommendation. The most adhered to recommendation was a physical exam (97%), and the least was a Pap smear (73%): 88% of survivors reported mammograms at recommended intervals. At the bivariate level, breast cancer survivors who were younger (t, df = 4.59, 711, p < .001), non-white, (t, df = -3.27, 267, p < .001), in a partnered relationship (t, df = 1.76, 54, p < .05), and with better QoL (r = -.09 p < .01) were more adherent to guideline-based care. A trend was observed for SCP: survivors who received care summaries (56%), including follow-up instructions (64%), and in written form (45%), were more likely to adhere (r = 0.05, p < .10). In a multivariable regression model adjusting for partnership status and SCP, younger survivors (B = 1.13, p < .001), who were non-white (B = 1.0, p < .01), and with better QoL (B = .09, p < .05) were more adherent. Conclusions: Survivors can benefit from guideline-based cancer prevention and screening with CBO-led support. Tailored SCP is essential to reinforce life-saving health behaviors and enhance follow-up adherence.

Journal of Clinical OncologyVol. 43(16_suppl)
Georgetown University (US), Georgetown University Medical Center (US), Vince Lombardi Cancer Clinic (US)
Openalex Percentile: Top 82%
Global Cancer Incidence and Screening
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