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Identification of health care needs of long-term breast cancer survivors among Israeli women

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Abstract

Purpose

Improvement in treatment has extended survival of breast cancer patients. Our study aimed to characterize health service use among long-term breast cancer survivors in Israel in order to identify and address specific needs of this subpopulation.

Methods

The study population included 250 women diagnosed with breast cancer, 8–12 years prior to study initiation (cases), and 250 individually matched cancer-free controls. Participants were recruited from the second largest Israeli HMO, and data were collected through personal interviews. ORs and 95 % CIs were estimated using conditional logistic regression and generalized estimating equations.

Results

Greater use of health services was observed among cases, compared to an age-matched comparison group, expressed by more visits to family physicians and specialists, longer duration of visits, more requests for referrals, more frequent contact with emergency services, and hospitalizations. The study groups were similar regarding socioeconomic variables, current smoking and physical activity, BMI, and prevalence of reported morbidity. Although 80 % of cases defined the family physician as their main treating physician, half still considered their oncologist responsible for cancer follow-up. Only 14.4 and 10.4 % of cases and controls, respectively, reported receiving psychological support during the year preceding the interview.

Conclusions

Further studies should assess the contribution of apprehension concerning health-related issues that still accompany breast cancer survivors, to the excess use of health services. Concern among family practitioners may contribute as well. In addition, our results emphasize the need to improve coordination between the disciplines of oncology and community medicine for the medical care of this group.

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Acknowledgments

This study was funded by a grant from the Health Council and the Israel National Institute for Health Policy Research (Grant number: 2011/50/E).

Compliance with ethical standards

ᅟ

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

All procedures followed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained from all participants included in the study.

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Authors and Affiliations

  1. Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, 5262000, Israel

    Lori Mandelzweig, Angela Chetrit, Tova Amitai, Bernice Oberman & Siegal Sadetzki

  2. Maccabi Health Services, Tel Aviv, Israel

    Nava Siegelmann Danieli

  3. Israel National Cancer Registry, Jerusalem, Israel

    Barbara Silverman

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Siegal Sadetzki

Authors
  1. Lori Mandelzweig
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  2. Angela Chetrit
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  3. Tova Amitai
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  4. Bernice Oberman
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  5. Nava Siegelmann Danieli
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  6. Barbara Silverman
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  7. Siegal Sadetzki
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Corresponding author

Correspondence to Siegal Sadetzki.

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Mandelzweig, L., Chetrit, A., Amitai, T. et al. Identification of health care needs of long-term breast cancer survivors among Israeli women. Support Care Cancer 24, 737–746 (2016). https://doi.org/10.1007/s00520-015-2836-0

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  • DOI: https://doi.org/10.1007/s00520-015-2836-0

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