TY - JOUR
T1 - Ductal carcinoma in situ (DCIS)
T2 - Posttreatment follow-up care among Latina and non-Latina White women
AU - López, Mónica E.
AU - Kaplan, Celia P.
AU - Nápoles, Anna M.
AU - Livaudais, Jennifer C.
AU - Hwang, E. Shelley
AU - Stewart, Susan L
AU - Bloom, Joan
AU - Karliner, Leah
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - DCIS
KW - Health disparities
KW - Language barriers
KW - Latina
KW - Posttreatment care
KW - Survivorship
UR - http://www.scopus.com/inward/record.url?scp=84876112086&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876112086&partnerID=8YFLogxK
U2 - 10.1007/s11764-012-0262-6
DO - 10.1007/s11764-012-0262-6
M3 - Article
C2 - 23408106
AN - SCOPUS:84876112086
VL - 7
SP - 219
EP - 226
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
SN - 1932-2259
IS - 2
ER -