Challenges associated with longitudinal survivorship research: attrition and a novel approach of reenrollment in a 6-year follow-up study of older breast cancer survivors
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- Clough-Gorr, K.M., Fink, A.K. & Silliman, R.A. J Cancer Surviv (2008) 2: 95. doi:10.1007/s11764-008-0049-y
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Breast cancer is the most common type of cancer among older women. The vast majority of women with breast cancer become long-term survivors.
We selected a convenience sample of women with: (1) stage I–IIIa disease, (2) age 65-years or older, and (3) permission from physician to contact. Data were collected over 6-years of follow-up from consenting patients’ medical records, telephone interviews, and the National Death Index. Before year 4 of follow-up we attempted to relocate women lost to follow-up using a single protocol and when successful, invited them to reenroll in the study. In this secondary data-analysis, baseline characteristics were compared among subjects with continuous follow-up, those who reenrolled, died, or were lost to follow-up.
Among 660 subjects, 177 had complete follow-up, 182 reenrolled after a period of non-participation, 171 died, and 130 were lost to follow-up. No important differences were found between reenrolled women and those with continuous follow-up or those lost to follow-up. There were nominal differences in age and comorbidity among women lost to follow-up compared to those with complete follow-up.
This study highlights challenges in longitudinal research of cancer survivorship, specifically the potential benefit of reenrollment.
Implications for cancer survivors
Our findings provide a novel and promising approach to surmount some of the challenges in longitudinal research aimed at enhancing knowledge and the overall cancer survivorship experience of older adults.
KeywordsAttrition Older adults Longitudinal research Breast cancer Reenrollment Survivor Survivorship
breast conserving surgery
body mass index
Centers for Disease Control
institutional review board
Mental Health Index 5
Medical Outcomes Study
National Death Index
primary care physician
Physical Function Index 10
Social Security Number