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Health care services use among long-term breast cancer survivors: a systematic review

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A Correction to this article was published on 27 May 2019

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Abstract

Purpose

Long-term breast cancer survivors are women surviving at least 5 years after diagnosis. This systematic review aimed to summarize the main characteristics and patterns of healthcare service use (frequency of visits, health providers visited, and preventive care performed) among long-term breast cancer survivors.

Methods

We used standard Cochrane Collaboration methods and searched the MEDLINE and EMBASE databases up to January 2018. We included English language observational studies reporting health service use among long-term cancer survivors. The quality of the studies was appraised through the ROBINS-I assessment tool. Two independent reviewers performed both the study quality assessment and the data extraction.

Results

A total of 23 observational studies were included that reported data on health services use by long-term breast cancer survivors. Despite heterogeneity among studies, about half of them reported that breast cancer survivors visited a medical provider at least once a year, as recommended by breast cancer survival guidelines. Although survivors visited medical providers with the recommended frequency, a substantial number used specialist care instead of primary care during follow-up. The results showed underuse of the recommended annual mammogram.

Conclusions

Long-term breast cancer survivors differ in their health services use with regard to the frequency of visits as well as the health providers seen. Our results indicate the need for active surveillance through primary care providers in coordination with specialized care.

Implications for cancer survivors

This review could help to standardize the management of breast cancer survivors and decision-makers to adapt their guidelines and clinical protocols.

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Change history

  • 27 May 2019

    The article Health care services use among long-term breast cancer survivors: a systematic review, written by Anna Jansana, Margarita Posso, Inmaculada Guerrero, Alexandra Prados-Torres, Maria Isabel Del Cura, Xavier Castells and Maria Sala, was originally published electronically.

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Acknowledgments

Anna Jansana is a Ph.D. candidate at the Methodology of Biomedical Research and Public Health program, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

The authors acknowledge the dedication and support of the SURBCAN Study Group (alphabetical order):

Hospital del Mar Medical Research Institute (IMIM), Barcelona: Mercè Abizanda, Mercè Comas, Laia Domingo, Talita Duarte, Anna Jansana, Javier Louro, Maria Sala.

Hospital Costa del Sol, University of Málaga: María del Carmen Martínez, Cristóbal Molina, María del Carmen Padilla, Maximino Redondo.

EpiChron Group of Chronic Disease Research, Zaragoza: Antonio Gimeno, Manuela Lanzuela, Beatriz Poblador, Alexandra Prados.

Primary Care Research Unit. Gerencia de Atención Primaria, Madrid: Ángel Alberquilla, Isabel del Cura, Antonio Díaz, Teresa Sanz.

Miguel Servet Health services and Cronicity Research Group, Navarra: Javier Baquedano, Rosana Burgui, Berta Ibáñez, María Concepción Moreno.

Funding

This study was funded by the Carlos III Health Institute through the project “PI16/0024” and “PI15/00098”and co-funded by FEDER (European Regional Development Fund/European Social Fund), and by the Research Network on Health Services in Chronic Diseases-REDISSEC (RD16/0001/0013).

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Authors and Affiliations

  1. Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain

    Anna Jansana, Margarita Posso, Xavier Castells & Maria Sala

  2. European Higher Education Area (EHEA) Doctoral Programme 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

    Anna Jansana

  3. Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain

    Anna Jansana, Margarita Posso, Alexandra Prados-Torres, Maria Isabel Del Cura, Xavier Castells & Maria Sala

  4. Grupo EpiChron de Investigación en Enfermedades Crónicas, IACS, IIS Aragon, Unidad Docente de Medicina Preventiva y Salud Pública, Hospital Universitario Miguel Servet, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain

    Inmaculada Guerrero & Alexandra Prados-Torres

  5. Primary Care Research Unit, Gerencia de Atención Primaria, Madrid, Spain

    Maria Isabel Del Cura

  6. Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Avenida de Atenas, 28922, Alcorcón, Madrid, Spain

    Maria Isabel Del Cura

  7. Autonomous University of Barcelona (UAB), 08193, Bellaterra, Barcelona, Spain

    Xavier Castells & Maria Sala

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  1. Anna Jansana
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Correspondence to Maria Sala.

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The authors declare that they have no conflict of interest. This protocol is registered in PROSPERO (2018:CRD42018089309).

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Jansana, A., Posso, M., Guerrero, I. et al. Health care services use among long-term breast cancer survivors: a systematic review. J Cancer Surviv 13, 477–493 (2019). https://doi.org/10.1007/s11764-019-00755-z

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