Increased primary healthcare utilisation among women with a history of breast cancer

Support Care Cancer. 2013 Apr;21(4):941-9. doi: 10.1007/s00520-012-1609-2. Epub 2012 Oct 4.

Abstract

Purpose: Little is known about the current role of the general practitioner (GP) in breast cancer follow-up care. This study explores primary healthcare use in the period after completion of primary breast cancer treatment.

Methods: A total of 336 women with a history of early-stage breast cancer treated with curative intent were identified in the primary care database of the Registration Network Groningen (RNG) (1998-2007) and matched with a reference population of 983 women without breast cancer on birth year and GP.

Results: Over the entire follow-up period (starting 1 year post-diagnosis), the median numbers of face-to-face contacts, drug prescriptions, and referrals in the patient group were significantly higher than those in the reference group: 4.0 vs. 3.2/year, 12.3 vs. 8.4/year, and 0.4 vs. 0.3/year, Mann-Whitney (M-W) test p < 0.001 for all differences. At least one annual face-to-face contact was observed for 96.7 % of patients and 92.9 % of women from the reference population (Chi-square test p = 0.011). More patients than women from the reference population had face-to-face contacts for reasons related to breast cancer or were prescribed hormone antagonists and aromatase inhibitors to treat breast cancer. The main predictor of higher rates of face-to-face contacts and drug prescriptions was a higher age at diagnosis.

Conclusions: This study shows increased primary healthcare utilisation among women with a history of breast cancer, especially among the elderly. When follow-up is transferred to the primary care setting, new responsibilities of GPs might be incorporated into existing primary healthcare delivery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / pathology
  • Continuity of Patient Care
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • General Practice / statistics & numerical data
  • Humans
  • Middle Aged
  • Netherlands
  • Primary Health Care / statistics & numerical data*
  • Young Adult