Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria.

Abstract

Objectives: The aim of this study is to describe the characteristics and predictors of discontinuation during follow-up care among breast cancer patients at the Radiation Oncology Department, University College Hospital (UCH), Ibadan, Nigeria.

Methodology: This is a retrospective cross-sectional study of 504 patients with histological diagnosis of breast cancer referred for radiotherapy to the breast or chest wall. Data extraction form was used to obtain information on sociodemographic and disease related variables and time to discontinuation of care. Discontinuation rates and its predictors were estimated using Kaplan-Meier, Log rank test, and Cox's regression method of analyses.

Results: Five hundred and four breast cancer patients were studied. The mean age was 47.7years, 58.2% presented late with advanced stage disease, and 40% and 39% had metastasis and anaemia, respectively. Seventy-seven percent of patients discontinued follow-up care before completion of ten-year period. The 5-year and 10-year discontinuation rates were 69.8% and 92.6%, respectively. The median discontinuation time was 44 months. Discontinuers were more likely to be older than the age of 45years {HR=1.415; 95% CI= 1.044 - 1.917}, have metastasis {HR=1.793; 95% CI=1.396 - 2.302}, be anaemic {HR=1.404; 95% CI = 1.120 - 1.760)}, and have late-stage disease {HR=1.310; 95% CI = 1.407-1.639)}.

Conclusion: Breast cancer care discontinuation is associated with late presentation and advanced stage of disease. Therefore a system of community follow-up care and public awareness about breast cancer symptoms is recommended to reduce late presentation and discontinuity of care.