Patient demographic and tumor characteristics influencing oncologist follow-up frequency in older breast cancer survivors.
Patient demographic and tumor characteristics influencing oncologist follow-up frequency in older breast cancer survivors.
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DOI：
10.1245/s10434-013-3170-8
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发表时间：
2013-12
影响因子：
3.7
通讯作者：
Greenberg CC
中科院分区：
文献类型：
--
作者：
Neuman HB;Weiss JM;Schrag D;Ronk K;Havlena J;LoConte NK;Smith MA;Greenberg CC
Although recommendations for breast cancer follow-up frequency exist, current follow-up guidelines are standardized, without consideration of individual patient characteristics. Some studies suggest oncologists are using these characteristics to tailor follow-up recommendations, but it is unclear how this is translating into practice. The objective was to examine current patterns of oncologist breast cancer follow-up and determine the association between patient and tumor characteristics and follow-up frequency. The Surveillance, Epidemiology and End Results (SEER)-Medicare database was used to identify stage I-III breast cancer patients diagnosed 2000-2007 (n=39,241). Oncologist follow-up visits were defined using Medicare specialty provider codes and the linked AMA Masterfile. Multinomial logistic regression determined the association between patient and tumor characteristics and oncologist follow-up visit frequency. Younger age (p<0.001), positive nodes (p<0.001), ER/PR positivity (p<0.001), and increasing treatment intensity (p<0.001) were most strongly associated with more frequent follow-up. However, after accounting for these characteristics, significant variation in follow-up frequency was observed. In addition to patient factors, the number and types of oncologists involved in follow-up was associated with follow-up frequency (p<0.001). Types of oncologists providing follow-up varied, with medical oncologists the sole providers of follow-up for 19-51% of breast cancer survivors. Overall, 58% of patients received surgical oncology and 51% undergoing radiation received radiation oncology follow-up, usually in combination with medical oncology. Significant variation in breast cancer follow-up frequency exists. Developing follow-up guidelines tailored for patient, tumor, and treatment characteristics, while also providing guidance on who should provide follow-up, has the potential to increase clinical efficiency.
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影响因子：
45.3
作者：
Kyndi, Marianne;Sorensen, Flemming B.;Overgaard, Jens
通讯作者：
Overgaard, Jens
影响因子：
3.8
作者：
Murphy, Caitlin C.;Bartholomew, L. Kay;Carpentier, Melissa Y.;Bluethmann, Shirley M.;Vernon, Sally W.
通讯作者：
Vernon, Sally W.
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
45.3
作者：
O'Connor, Erin S.;Greenblatt, David Yu;Smith, Maureen A.
通讯作者：
Smith, Maureen A.
影响因子：
45.3
作者：
Millar, Ewan K. A.;Graham, Peter H.;Sutherland, Robert L.
通讯作者：
Sutherland, Robert L.