Preventive Care and Screening Adherence Among Women Surviving Breast Cancer

<b>Background/Objectives</b>: Routine preventive care, including physical examinations, mammography, and cervical cancer screening, is critical for long-term health maintenance and recurrence surveillance among breast cancer survivors. Community-based organizations (CBOs) may play a key role in supporting adherence to these services through education, navigation, and survivorship care planning. <b>Methods</b>: A secondary analysis was conducted using data from <i>N</i> = 777 breast cancer survivors who contacted a national cancer-focused CBO for resources, including no-cost patient navigation. Preventive care adherence was measured via a composite index based on self-reported receipt of physical exams, mammograms, and Pap smears at guideline-recommended intervals. Patient-reported outcomes were assessed 30 days post-contact, including Survivorship Care Planning (SCP) receipt and quality of life (QoL). <b>Results</b>: Adherence to all three guideline-based screenings was reported by 66% of BCS, 29% adhered to two, and 6% to one or fewer. Physical exams had the highest adherence rate (97%), followed by mammograms (88%) and Pap smears (73%). Bivariate analyses showed higher adherence among younger survivors (t = 4.59, df = 711, <i>p</i> < 0.001), non-white survivors (t = -3.27, df = 267, <i>p</i> < 0.001), those in partnered relationships (t = 1.76, df = 54, <i>p</i> < 0.05), and individuals with better QoL (r = -0.09, <i>p</i> < 0.01). Receipt of SCP components was associated with a trend toward improved adherence: 56% received a care summary, 64% received follow-up instructions, and 45% received written materials (r = 0.05, <i>p</i> < 0.10). In multivariable regression adjusting for partnership status and SCP receipt, younger age (B = 1.13, <i>p</i> < 0.001), non-white race/ethnicity (B = 1.00, <i>p</i> < 0.01), and higher QoL scores (B = 0.09, <i>p</i> < 0.05) were significantly associated with greater adherence. <b>Conclusions</b>: Engagement with a CBO was associated with high levels of adherence to preventive care among breast cancer survivors-especially those who were younger, non-white, and with better QoL. SCP, particularly when delivered in written form with follow-up instructions, may support improved adherence. These findings highlight the value of CBO-led survivorship support in promoting long-term health maintenance for breast cancer survivors.

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Publication Details

Journal
Cancers
Published
2025-08-29
DOI
https://doi.org/10.3390/cancers17172837
Citations
1
Primary Topic
Economic and Financial Impacts of Cancer
Type
article
Field-Weighted Citation Impact
3.13

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article

Preventive Care and Screening Adherence Among Women Surviving Breast Cancer

Marcelo M. Sleiman, Adina Fleischmann, D. Liu, Kenneth P. Tercyak et al.
1 citations
Cancers
Economic and Financial Impacts of Cancer
3.13
article

Preventive Care and Screening Adherence Among Women Surviving Breast Cancer

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

Abstract

<b>Background/Objectives</b>: Routine preventive care, including physical examinations, mammography, and cervical cancer screening, is critical for long-term health maintenance and recurrence surveillance among breast cancer survivors. Community-based organizations (CBOs) may play a key role in supporting adherence to these services through education, navigation, and survivorship care planning. <b>Methods</b>: A secondary analysis was conducted using data from <i>N</i> = 777 breast cancer survivors who contacted a national cancer-focused CBO for resources, including no-cost patient navigation. Preventive care adherence was measured via a composite index based on self-reported receipt of physical exams, mammograms, and Pap smears at guideline-recommended intervals. Patient-reported outcomes were assessed 30 days post-contact, including Survivorship Care Planning (SCP) receipt and quality of life (QoL). <b>Results</b>: Adherence to all three guideline-based screenings was reported by 66% of BCS, 29% adhered to two, and 6% to one or fewer. Physical exams had the highest adherence rate (97%), followed by mammograms (88%) and Pap smears (73%). Bivariate analyses showed higher adherence among younger survivors (t = 4.59, df = 711, <i>p</i> < 0.001), non-white survivors (t = -3.27, df = 267, <i>p</i> < 0.001), those in partnered relationships (t = 1.76, df = 54, <i>p</i> < 0.05), and individuals with better QoL (r = -0.09, <i>p</i> < 0.01). Receipt of SCP components was associated with a trend toward improved adherence: 56% received a care summary, 64% received follow-up instructions, and 45% received written materials (r = 0.05, <i>p</i> < 0.10). In multivariable regression adjusting for partnership status and SCP receipt, younger age (B = 1.13, <i>p</i> < 0.001), non-white race/ethnicity (B = 1.00, <i>p</i> < 0.01), and higher QoL scores (B = 0.09, <i>p</i> < 0.05) were significantly associated with greater adherence. <b>Conclusions</b>: Engagement with a CBO was associated with high levels of adherence to preventive care among breast cancer survivors-especially those who were younger, non-white, and with better QoL. SCP, particularly when delivered in written form with follow-up instructions, may support improved adherence. These findings highlight the value of CBO-led survivorship support in promoting long-term health maintenance for breast cancer survivors.

CancersVol. 17(17)
Georgetown University (US), Georgetown University Medical Center (US)
Centers for Disease Control and Prevention, National Cancer Institute
Openalex Percentile: Top 7%
Economic and Financial Impacts of Cancer
3.13
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