Ductal carcinoma in situ (DCIS): Posttreatment follow-up care among Latina and non-Latina White women

Mónica E. López, Celia P. Kaplan, Anna M. Nápoles, Jennifer C. Livaudais, E. Shelley Hwang, Susan L Stewart, Joan Bloom, Leah Karliner

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background: There is a lack of information about posttreatment care among patients with ductal carcinoma in situ (DCIS). This study compares posttreatment care by ethnicity-language and physician specialty among Latina and White women with DCIS. Methods: Latina and White women diagnosed with DCIS between 2002 and 2005 identified through the California Cancer Registry completed a telephone survey in 2006. Main outcomes were breast surveillance, lifestyle counseling, and follow-up physician specialty. Key results: Of 742 women (396 White, 349 Latinas), most (90 %) had at least one clinical breast exam (CBE). Among women treated with breast-conserving surgery (BCS; N = 503), 76 % had received at least two mammograms. While 92 % of all women had follow-up with a breast specialist, Spanish-speaking Latinas had the lowest specialist follow-up rates (84 %) of all groups. Lifestyle counseling was low with only 53 % discussing exercise, 43 % weight, and 31 % alcohol in relation to their DCIS. In multivariable analysis, Spanish-speaking Latinas with BCS had lower odds of receiving the recommended mammography screening in the year following treatment compared to Whites (OR 0. 5; 95 % CI, 0. 2-0. 9). Regardless of ethnicity-language, seeing both a specialist and primary care physician increased the odds of mammography screening and CBE (OR 1. 6; 95 % CI, 1. 2-2. 3 and OR 1. 9; 95 % CI, 1. 3-2. 8), as well as having discussions about exercise, weight, and alcohol use, compared to seeing a specialist only. Conclusions: Most women reported appropriate surveillance after DCIS treatment. However, our results suggest less adequate follow-up for Spanish-speaking Latinas, possibly due to language barriers or insurance access. Implications for Cancer Survivors: Follow-up with a primary care provider in addition to a breast specialist increases receipt of appropriate follow-up for all women.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalJournal of Cancer Survivorship
Volume7
Issue number2
DOIs
StatePublished - 2013

Keywords

  • DCIS
  • Health disparities
  • Language barriers
  • Latina
  • Posttreatment care
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

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    López, M. E., Kaplan, C. P., Nápoles, A. M., Livaudais, J. C., Hwang, E. S., Stewart, S. L., Bloom, J., & Karliner, L. (2013). Ductal carcinoma in situ (DCIS): Posttreatment follow-up care among Latina and non-Latina White women. Journal of Cancer Survivorship, 7(2), 219-226. https://doi.org/10.1007/s11764-012-0262-6