Abstract PO4-12-02: Screening adherence for second primary malignancies in breast cancer survivors: a cross-sectional study assessing behaviors, facilitators, and barriers to enhance quality care
Authors: Mesa-Chavez Fernanda , Salazar-Alejo Misael , Villarreal-Garza Cynthia 
Published: May 2024

Background: Continuous advancements in medical care have significantly increased the life expectancy of breast cancer (BC) patients. Due to this increased lifespan, combined with genetic, hormonal and environmental factors, BC patients have an increased risk of developing a 2nd primary malignancy. Therefore, regular screening for other types of cancer is of utmost importance for comprehensive care of BC survivors (BCS). The aim of this study was to evaluate the level of compliance with screening for cervical, lung, and colorectal cancer among BCS. Additionally, the study aimed to identify the facilitators and barriers influencing cancer screening (CS) adherence.

Methods: An online survey for BCS was developed to assess sociodemographic data, risk perception of developing a 2nd primary malignancy, attitudes towards CS, and compliance with CS. It was distributed through the social media of Mexican oncology-related NGOs.

Results: In total, 52 BCS (median age: 44 years, range: 28-67 years) answered the survey. Most were diagnosed with stage III (38%) or II (29%) BC. The majority had completed at least high-school education (90%), had public health insurance (60%) or no insurance (25%), and reported a monthly income &lt; 500 USD (52%). A total of 3 (6%) cases of 2nd primary malignancies were reported, including 2 cases of contralateral BC and 1 cervical carcinoma.

Among 50 participants with an indication for cervical CS, 37 (74%) had a pap smear within the past 3 years. Only 7/24 (29%) eligible participants underwent colorectal CS within the last 10 years. Screening modalities included 6 colonoscopies and 1 occult blood test. The primary reason for non-compliance in both cervical and colorectal CS was the absence of a physician's recommendation, accounting for 79% and 88% of the cases, respectively. None of the participants had an indication for lung CS, thus no low-dose computed tomographies were performed for this purpose.

Participants demonstrated a mean knowledge score of 72/100 (SD=19) regarding CS. Most respondents mentioned that, compared to the general population, they considered themselves to be at no/very low/low risk of developing cervical (75%), colon (73%), or lung cancer (75%).

In terms of attitudes towards CS, an overwhelming majority of participants (98%) affirmed that BCS should undergo screening for other types of cancer. Most stated that, if recommended by a physician, they would agree/strongly agree (96%) to undergo screening for other neoplasms. Nearly all agreed/strongly agreed (98%) that being screened for other types of cancer would be beneficial for their own health; and agreed/strongly agreed (98%) that CS is the most effective way to approach other types of cancer. Additionally, most agreed/strongly agreed (96%) their CS would benefit their family members.

On univariate analysis, no sociodemographic or clinical factors were associated with CS adherence. However, it is important to note that the study may have been underpowered to detect significant associations due to the limited sample size.

Conclusion: In conclusion, even though most BCS acknowledge its importance, screening for 2nd primary malignancies in this group exhibits suboptimal rates. This study highlights the potential role that BC oncologists could play on increasing CS uptake by reminding patients of their corresponding recommendations to detect other types of cancer. Further research is crucial to enhance our understanding of the key factors influencing these outcomes and to contribute to the development of targeted strategies aimed at enhancing CS adherence.

Citation Format: Fernanda Mesa-Chavez, Misael Salazar-Alejo, Cynthia Villarreal-Garza. Screening adherence for second primary malignancies in breast cancer survivors: a cross-sectional study assessing behaviors, facilitators, and barriers to enhance quality care [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-12-02.