Health care utilisation and characteristics of long-term breast cancer survivors: nationwide survey in Denmark

Eur J Cancer. 2009 Mar;45(4):625-33. doi: 10.1016/j.ejca.2008.09.027. Epub 2008 Nov 25.

Abstract

Aim: To investigate long-term female breast cancer survivors' (BCS') health care utilisation, health, and employment.

Methods: An age-stratified random sample of 2000 female breast cancer survivors (BCS) 5-15 years after primary surgery without recurrence was drawn from the Danish Breast Cancer Cooperative Group register. A self-administered questionnaire assessed sociodemography, health care utilisation, employment, and health-related quality of life (HRQOL). Associations with breast cancer treatment were investigated.

Results: Response rate was 79%. Significantly more BCS than the general women population reported health care utilisation (61% versus. 56%; age-standardised risk ratio (SRR): 1.10; 95% confidence interval (CI) 1.05-1.15), but significantly fewer BCS were disability pensioners (15% versus 19%; SRR: 0.77; 95% CI 0.64-0.93). 'Daily activities limited due to sequelae' were reported by 20%, and 'stopped working/changed job due to sequelae' by 11% of BCS. In multiple logistic regression analysis, radiotherapy (odds ratio (OR) 2.54; 95% CI 1.34-4.80) and endocrine therapy (OR 2.48; 95% CI 1.13-5.45, postmenopausal women only) were significantly related to 'stopped working/changed job due to sequelae'. Time since surgery 5-10 years (versus >10 years) was significantly associated with 'daily activities limited due to sequelae' (OR 2.02; CI 1.43-2.84), which, in turn, was significantly related to poorer HRQOL (all p<0.05). Chemotherapy, receptor status, and protocol allocation did not show significant associations in any analyses.

Conclusion: Significantly more BCS reported health care utilisation. Radiotherapy, shorter time since surgery, and endocrine therapy predicted daily activity and work limitations due to sequelae.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Attitude to Health
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / rehabilitation*
  • Breast Neoplasms / surgery
  • Denmark
  • Employment / statistics & numerical data
  • Female
  • Health Services / statistics & numerical data*
  • Health Status
  • Health Surveys
  • Humans
  • Mastectomy / methods
  • Middle Aged
  • Motor Activity
  • Quality of Life
  • Radiotherapy, Adjuvant
  • Sick Leave / statistics & numerical data
  • Survivors / statistics & numerical data*