Abstract PS9-25: Receipt of preventive care and health promotion in a cohort of early stage breast cancer survivors
Authors: Schumacher Jessica R. , Haine James E , Tevaarwerk Amye J , Kwekkeboom Kristine L , Stankowski-Drengler Trista J , Breuer Catherine R. , Tucholka Jennifer L , Maxcy Courtney , Smith Maureen A , Neuman Heather B. 
Published: February 2021

Abstract
Introduction: Prior studies have demonstrated that breast cancer survivors are less likely to receive primary care preventive services than non-cancer patients. However, even recent studies have largely assessed survivors diagnosed over a decade ago. Further, studies have not considered patient receipt of health promotion guidance, critical to maintaining a healthy lifestyle. We examined the receipt of preventive care and health promotion in a modern cohort of early stage breast cancer survivors seen within our breast program. Methods: A cross-sectional cohort of women with a history of stage I/II, hormone receptor +, HER2neu- breast cancer within 5 years from diagnosis who did not receive chemotherapy were consented (n=101). Survivors completed a survey evaluating aspects of survivorship, including provider discussions regarding health promotion. Electronic medical record (EMR) abstraction captured receipt of preventive care (see Table). We excluded survivors with a primary care provider outside our health care system to ensure complete capture of screening (n=36). Results: Our final cohort (n=62) was a median 2 years from diagnosis (range 0.5-5 years) and a median age of 61 years (range 30-84). Most were stage I (73%) and white (95%). The majority of survivors received preventive care (Table). Survivors were less likely to report health promotion guidance from their provider, including: discussing “things you could do to improve your health” (66%), getting “help you wanted to make changes in your habits” (52%), discussing “how much or what kinds of food you eat” (24%), and “how much or what kind of exercise” (42%). Conclusion: In a modern cohort of early stage breast cancer survivors from a single breast center homed within our health care system, documented receipt of preventive care was high (≥75%). These high rates may reflect the implementation of EMRs (which could facilitate care coordination and provide best practice alerts), participation of our health system in state-wide quality improvement programs, and/or heightened awareness of the importance of preventive care by oncology providers. However, survivors perceive limited discussions surrounding health promotion, presenting an opportunity to improve survivorship care.
Table. Summary of Receipt of Preventive Care for Early Stage Breast Cancer SurvivorsRecommended Preventive Care ServicesDefinition of ReceiptProportion of Eligible PatientsInfluenza vaccineAny since diagnosis*76% (44/58)Pneumococcal vaccineIf &gt;65 yo, any since diagnosis*93% (38/41)Lipid screeningAny within 5 years84% (52/62)Colorectal cancer screeningIf &gt;50 yo, colonoscopy within 10 years, cologuard within 5 years, fecal occult test within 1 year77% (37/48)Cervical cancer screeningIf cervix present and &lt;65 yo, within 5 years79% (27/34)Mammogram screeningIf breast tissue present, annual100% (56/56)*if &lt;1 year from diagnosis, ineligible for this metric
Citation Format: Jessica R. Schumacher, James E Haine, Amye J Tevaarwerk, Kristine L Kwekkeboom, Trista J Stankowski-Drengler, Catherine R. Breuer, Jennifer L Tucholka, Courtney Maxcy, Maureen A Smith, Heather B. Neuman. Receipt of preventive care and health promotion in a cohort of early stage breast cancer survivors [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-25.