Background/Objectives: Routine preventive care, including physical examinations, mammography, and cervical cancer screening, is critical for long-term health maintenance and recurrence surveillance among breast cancer survivors. Community-based organizations (CBOs) may play a key role in supporting adherence to these services through education, navigation, and survivorship care planning.Methods: A secondary analysis was conducted using data fromN= 777 breast cancer survivors who contacted a national cancer-focused CBO for resources, including no-cost patient navigation. Preventive care adherence was measured via a composite index based on self-reported receipt of physical exams, mammograms, and Pap smears at guideline-recommended intervals. Patient-reported outcomes were assessed 30 days post-contact, including Survivorship Care Planning (SCP) receipt and quality of life (QoL).Results: Adherence to all three guideline-based screenings was reported by 66% of BCS, 29% adhered to two, and 6% to one or fewer. Physical exams had the highest adherence rate (97%), followed by mammograms (88%) and Pap smears (73%). Bivariate analyses showed higher adherence among younger survivors (t = 4.59, df = 711,p< 0.001), non-white survivors (t = −3.27, df = 267,p< 0.001), those in partnered relationships (t = 1.76, df = 54,p< 0.05), and individuals with better QoL (r = −0.09,p< 0.01). Receipt of SCP components was associated with a trend toward improved adherence: 56% received a care summary, 64% received follow-up instructions, and 45% received written materials (r = 0.05,p< 0.10). In multivariable regression adjusting for partnership status and SCP receipt, younger age (B = 1.13,p< 0.001), non-white race/ethnicity (B = 1.00,p< 0.01), and higher QoL scores (B = 0.09,p< 0.05) were significantly associated with greater adherence.Conclusions: Engagement with a CBO was associated with high levels of adherence to preventive care among breast cancer survivors—especially those who were younger, non-white, and with better QoL. SCP, particularly when delivered in written form with follow-up instructions, may support improved adherence. These findings highlight the value of CBO-led survivorship support in promoting long-term health maintenance for breast cancer survivors.
背景/目的：常规预防性护理，包括体格检查、乳腺X线摄影和宫颈癌筛查，对于乳腺癌幸存者的长期健康维护及复发监测至关重要。社区组织可通过教育、导诊和生存护理计划制定，在支持患者坚持接受这些服务方面发挥关键作用。 方法：本研究对777名乳腺癌幸存者的数据进行了二次分析，这些患者曾向一家全国性癌症服务社区组织寻求资源支持，包括免费患者导诊服务。预防性护理依从性通过复合指标进行评估，该指标基于患者自述在指南推荐间隔期内接受体格检查、乳腺X线摄影和巴氏涂片检查的情况。在联系社区组织30天后评估患者报告结局，包括生存护理计划接收情况及生活质量。 结果：66%的乳腺癌幸存者报告遵循了全部三项指南推荐的筛查，29%遵循两项，6%遵循一项或更少。体格检查依从率最高（97%），其次为乳腺X线摄影（88%）和巴氏涂片检查（73%）。双变量分析显示，年轻幸存者（t=4.59，df=711，p<0.001）、非白人幸存者（t=-3.27，df=267，p<0.001）、有伴侣者（t=1.76，df=54，p<0.05）及生活质量较高者（r=-0.09，p<0.01）的依从性更高。接收生存护理计划组件与依从性改善趋势相关：56%收到护理摘要，64%收到随访指导，45%收到书面材料（r=0.05，p<0.10）。在调整伴侣状态和生存护理计划接收情况的多变量回归分析中，年龄较轻（B=1.13，p<0.001）、非白人种族/民族（B=1.00，p<0.01）及较高生活质量评分（B=0.09，p<0.05）与更高依从性显著相关。 结论：参与社区组织服务与乳腺癌幸存者较高的预防性护理依从性相关，特别是在年轻、非白人及生活质量较高的群体中。生存护理计划，尤其是包含随访指导的书面形式，可能有助于提升依从性。这些发现凸显了社区组织主导的生存支持在促进乳腺癌幸存者长期健康维护方面的重要价值。
Preventive Care and Screening Adherence Among Women Surviving Breast Cancer
肿瘤(癌症)患者之家