Predictors and Characteristics of Patients Lost to Breast Cancer Follow-up Care in Southeastern Nigeria

Abstract

Background: Breast cancer is the commonest cancer in Nigeria and a significant proportion of patients discontinue follow-up care after treatment. The aim of this study is to describe the characteristics and predictors of loss to follow-up among breast cancer patients on follow-up care at Radiotherapy Department, University College Hospital (UCH), Ibadan. Methodology: This is a retrospective study of patients with histological diagnosis of breast cancer post- radiotherapy and/or chemotherapy with or without surgery between 1st January 2005 to 31st December 2014. Data extraction form was used to obtain information on socio-demographic and disease-related variables and time to loss to follow-up. Loss to follow-up rates and their predictors were estimated using Kaplan Meier, Log-rank test, and Cox's regression methods of analyses. Results: Five hundred and four breast cancer patients were studied. Their mean age was 47.7 (±10.6) years, 58.2% presented late with advanced stage disease, 40%, and 39% had metastasis and anaemia respectively. The 5-year and 10-year loss to follow-up rates were 69.8% and 92.6% respectively. The median loss to follow-up time was 44 months. Patients loss to follow-up were more likely to be older than 45 years [HR=1.415; 95% CI, 1.044- 1.917], have metastasis [HR=1.793; 95% CI, 1.3962.302], be anaemic [HR=1.404; 95% CI, 1.1201.760)] and have late stage disease [HR=1.310; 95% CI, 1.047-1.639)]. Conclusion: Breast cancer patients studied have a high loss to follow-up rates due to due to late presentation and high disease burden-related factors.