Changes in patient‐reported primary care engagement in and communication about survivorship care from initial breast cancer treatment to longer‐term survivorship

Abstract Background The objective of this study was to evaluate changes in primary care physicians' (PCPs') engagement and communication from initial breast cancer treatment through longer term survivorship and the patient characteristics associated with low PCP engagement and communication during longer term survivorship. Methods The iCanCare study is a longitudinal study of women who were diagnosed with breast cancer in 2014–2015 in the Los Angeles and Georgia Surveillance, Epidemiology and End Results registries. Women were surveyed during initial treatment (baseline) and again approximately 6 years later in survivorship (follow‐up; overall N = 1412; 60% response rate; n = 825 after exclusions). Respondents were asked how informed their PCP was about their breast cancer care (engagement) and how often they talked with their PCP about their breast cancer care (communication). The authors evaluated changes in PCP engagement and communication from baseline to follow‐up and identified patient characteristics associated with low engagement and communication at follow‐up using weighted, multivariable‐adjusted logistic regression. Results In this population‐based sample of 825 women, 39.5% reported worse PCP communication and 37.9% reported worse PCP engagement during longer term survivorship compared with initial treatment. Women who reported high baseline PCP engagement and communication were one half as likely to report low engagement and communication during longer term survivorship (adjusted odds ratio, 0.50 [95% confidence interval, 0.37–0.68] and 0.43 [95% confidence interval, 0.32–0.58], respectively) compared with women who reported low baseline PCP engagement and communication. Conclusions Many breast cancer survivors experienced worsening PCP engagement and communication from initial treatment to longer term survivorship despite initially high reports. Promoting sustained PCP engagement and communication could be a promising strategy for improving survivorship care delivery.