Preventive Care and Screening Adherence Among Women Surviving Breast Cancer

Abstract

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 from N = 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.