Journal of Cancer Survivorship

, Volume 2, Issue 2, pp 95–103 | Cite as

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

  • Kerri M. Clough-Gorr
  • Aliza K. Fink
  • Rebecca A. Silliman



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.


Attrition Older adults Longitudinal research Breast cancer Reenrollment Survivor Survivorship 



breast conserving surgery


body mass index


Centers for Disease Control


institutional review board


Los Angeles


medical doctor


Mental Health Index 5




Medical Outcomes Study


North Carolina


National Death Index


primary care physician


Physical Function Index 10


Rhode Island


Social Security Number


United States.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Kerri M. Clough-Gorr
    • 1
    • 3
  • Aliza K. Fink
    • 2
  • Rebecca A. Silliman
    • 1
  1. 1.Boston University Schools of Medicine and Public HealthBostonUSA
  2. 2.Macro International Inc.BethesdaUSA
  3. 3.Boston University Medical CenterBostonUSA

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