This study aimed to evaluate health service utilization in Spain among long-term breast cancer survivors and to compare it with that among women with no history of breast cancer.
Study based on the SURBCAN cohort includes a sample of long-term breast cancer survivors and a sample of women without breast cancer from 5 Spanish regions. Healthcare utilization was assessed through primary care, hospital visits, and tests during the follow-up period (2012 to 2016) by using electronic health records. Annual contact rates to healthcare services were calculated, and crude and multivariate count models were fitted to estimate the adjusted relative risk of healthcare services use.
Data were obtained from 19,328 women, including 6512 long-term breast cancer survivors. Healthcare use was higher among breast cancer survivors (20.9 vs 16.6; p < 0.0001) and decreased from >10 years of survival. Breast cancer survivors who underwent a mastectomy were more likely to have a primary care visit (RR = 3.10 95% CI 3.08–3.11). Five to ten years survivors were more likely to have hospital inpatient visits and imaging test compared to women without breast cancer (RRa = 1.35 95% CI 1.30–1.39 and RRa = 1.27 95% CI 1.25–1.29 respectively).
This study shows higher use of health services in long-term breast cancer survivors than in women without breast cancer regardless of survival time.
Implications for Cancer Survivors
These results help to estimate the health resources needed for the growing group of breast cancer survivors and to identify risk factors that drive higher use of health services.
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Anna Jansana is a Ph.D. candidate at the Methodology of Biomedical Research and Public Health program, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain (European Higher Education Area Doctoral Program in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain).
The authors acknowledge the dedication and support of the SURBCAN Study Group (alphabetical order): IMIM (Hospital del Mar Medical Research Institute), Barcelona: Mercè Abizanda, Xavier Castells, Mercè Comas, Laia Domingo, Talita Duarte, Anna Jansana, Javier Louro, and María Sala. Hospital Costa del Sol, University of Malaga: María del Carmen Martínez, Cristóbal Molina, María del Carmen Padilla, and Maximino Redondo. Grupo EpiChron de Investigación en Enfermedades Crónicas, del Instituto Aragonés de Ciencias de la Salud, Aragón: Antonio Gimeno, Manuela Lanzuela, Beatriz Poblador, and Alexandra Prados. Primary Care Research Unit. Gerencia de Atención Primaria, Hospital Universitario 12 de Octubre, Madrid: Ángel Alberquilla, Isabel del Cura, Antonio Díaz, Teresa Sanz, Guillermo Pérez, Ana María Muñoz, Francisco Javier Salamanca, and Óscar Toldos. Grupo de investigación en servicios sanitarios y cronicidad de la Fundación Miguel Servet, Navarra: Javier Baquedano, Rossana Burgui, Javier Gorricho, Berta Ibáñez, Conchi Moreno, and Ibai Tamayo.
This work was supported by Carlos III Health Institute [PI16/00244] and [PI19/00056] and by FEDER (European Regional Development Fund/European Social Fund) and by the Research Network on Health Services in Chronic Diseases [RD16/0001/0013].
Ethics approval and consent to participate
This article does not contain any studies with human participants or animals performed by any of the authors. This project was accepted by the Clinical Research Ethics Committee of Parc de Salut Mar (n°2016/6835/I).
For this type of study, formal consent is not required.
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Jansana, A., Domingo, L., Ibañez, B. et al. Use of health services among long-term breast cancer survivors in Spain: longitudinal study based on real-world data. J Cancer Surviv (2021). https://doi.org/10.1007/s11764-021-01011-z
- Breast cancer
- Health services research
- Cancer survivors
- Primary care
- Survival care
- Real-world data