Use of health-care services during chemotherapy for breast cancer

Eur J Cancer. 2012 Dec;48(18):3328-34. doi: 10.1016/j.ejca.2012.04.024. Epub 2012 Jun 8.


Aim of the study: The authors analyse the effect of chemotherapy on the use of additional health-care resources and report the clinical and demographic factors associated with such use.

Patients and methods: In women with breast cancer, eligible to receive first-line (neo)-adjuvant or palliative chemotherapy, consultations with health-care practitioners (general practitioners [GPs] and specialists) and admissions to emergency department and to hospital were prospectively recorded. Differences were studied according to these clinical and demographic variables: age, tumour stage, performance status, weight, height, body mass index, surgery type, chemotherapy type, number of courses, comorbidity, marital status, educational level, social status and occupational status.

Results: Among 268 patients, 124 (42.2%) required one or more non-protocol health-care encounters. 180 visits were generated (GP 23.3%, specialist 35.5%, emergency department admission 21.1%, hospital admission 8.3%, others 3.3% and more than one resource 8.3%). Of total consultations 150 (83.3%) were chemotherapy-related. The number of visits was higher in the first courses. Fever and infection were the most frequent reasons for consultation in all resources. The dependent variable: 'need for non-protocol health-care encounter in any course' was statistically associated with age (p=0.002) and marital status (p=0.021); no association was found with other variables. In multivariate analysis, age (p=0.001) and marital status (p=0.009) remained statistically significant. Younger and married patients consumed less extra health resources.

Concluding statement: Many patients receiving chemotherapy consume health-care resources in addition to their routine visits, usually treatment-related. Patients consult less in the later courses. Older and unmarried women in particular need extra care during chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anthropometry
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / surgery
  • Breast Neoplasms, Male / drug therapy
  • Breast Neoplasms, Male / epidemiology
  • Breast Neoplasms, Male / surgery
  • Combined Modality Therapy
  • Comorbidity
  • Disease Susceptibility
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Fever / epidemiology
  • Health Care Surveys
  • Health Services / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Infections / epidemiology
  • Male
  • Marital Status
  • Middle Aged
  • Neoadjuvant Therapy
  • Office Visits / statistics & numerical data
  • Palliative Care
  • Prospective Studies
  • Socioeconomic Factors
  • Spain
  • Young Adult