Patient-reported duplication and missed breast cancer survivorship care more than 5 years after initial treatment

PURPOSE: Little is known about the long-term coordination of breast cancer survivorship care, including duplicated and/or missed care and whether disparities exist. We investigated patients' perceptions of survivorship care coordination more than 5 years post-initial treatment, and examined differences by survivorship care delivery model, and patient characteristics. METHODS: The iCanCare study is a longitudinal study of women diagnosed with early-stage breast cancer in 2014-2015 identified in the Los Angeles and Georgia Surveillance, Epidemiology and End Results registries. Women were surveyed during initial treatment and again 6-7 years later (2021-2022) (N = 1412, 60% response rate). Respondents were asked how often survivorship services were ordered twice (duplication) or key aspects of care were missed, and who led their care delivery. Associations of participant characteristics and survivorship care delivery model with duplication and missed care were estimated using multivariable logistic regression. RESULTS: Overall, 29% of participants reported duplication, and 30% reported missed survivorship care. Latina women (vs. white) and those with 2 or more comorbidities (vs. 0) were more likely to report duplicated care (aOR: 1.71, 95% CI: 1.04-2.80, comorbidities aOR: 2.04, 1.27, 3.26). Women who reported oncologist-led care (vs. PCP-led) were more likely to report duplicated care (aOR: 2.17, 1.40-3.35) but were less likely to report missed care (aOR: 0.62, 0.42, 0.93). CONCLUSION: A notable proportion of long-term breast cancer survivors reported duplicated and/or missed survivorship care, with Latina women more often reporting duplicated care. IMPLICATIONS FOR CANCER SURVIVORS: These findings highlight persistent challenges of coordinating long-term survivorship care and the need for scalable strategies and incentives to promote coordination across oncology and primary care teams.