Breast cancer survivors experience significant burden from non-cancer chronic conditions, particularly cardio-metabolic, osteoporosis and mental illness. Little is known about how these conditions impact wellbeing and how well they are managed. We conducted an online survey of breast cancer survivors to examine the burden of chronic disease, its impact, care received, and its alignment with principles of chronic disease management.
A 22-item study-specific online survey was developed and pilot tested. The survey incorporated questions about presence of chronic conditions using the Charlson Comorbidity Index (CCI), functional status using Vulnerable Elders Survey (VES), and perceived quality of care for cancer and non-cancer conditions using the Patient Assessment of Care for Chronic Conditions Survey (PACIC). Members of Breast Cancer Network Australia (BCNA) were invited via email to complete the survey either online or through direct mail.
The survey was sent to 2,198 members of BCNA and 177 responses were received (8.1%). All respondents were women aged 32-88 (median 60 yrs). The majority were Caucasian (171; 99%), married (116, 68%) and had private insurance (137; 80%). Other health conditions were reported by 159 (89%) with the most common conditions reported including chronic pain, fatigue, peripheral neuropathy and mental disorders. Good to excellent health was reported by 120 (73%). When asked about non-cancer chronic condition management, <20% were routinely asked about management goals, helped to set specific goals or asked about health habits. Less than 40% were asked about any problems with medications. These strategies were even less likely applied with regards to cancer-specific care.
Chronic conditions are common among breast cancer survivors. In this population of survivors with good health status and high rates of private insurance, the management of chronic conditions, and the management of breast cancer itself demonstrate limited alignment with established chronic disease management principles.