Unmet needs among long-term breast cancer survivors

Breast cancer survivors experience unmet needs throughout survivorship. We described the burden of unmet needs among ≥ 10-year survivors.

We used the Cancer Survivors Unmet Needs Assessment (CaSun) to characterize unmet needs (information, quality of life, emotional and relationships, life perspective) among participants in Phase 3 of the Carolina Breast Cancer Study, a population-based study of breast cancer survivors diagnosed from 2008 to 2013. We calculated the prevalence of having ≥ 5 unmet needs (%) and estimated prevalence differences (PD) and 95% confidence intervals (CI) using generalized linear models with a binomial distribution to describe the burden of unmet needs across patient, clinical, and treatment characteristics.

We included 1445 women who completed the CaSun an average of 11.2 (SD = 0.6) years post-diagnosis. The sample was roughly balanced between Black (46.2%) and White (53.8%) participants. Overall, 27.1% of participants reported ≥ 5 unmet needs. We observed a higher burden of unmet needs among Black women compared to White women (PD: 14.2; 95% CI 9.6, 18.7) and among women < 50 years of age compared to women ≥ 50 (PD: 9.5; 95% CI 5.0, 13.9). Notably, women characterized as having "more barriers to care" had the highest prevalence of unmet needs in our study, with 28.6 percentage points higher prevalence compared to women with "fewer barriers to care" (95% CI 18.7, 38.5).

Black, younger, and socioeconomically disadvantaged women had a higher burden of long-term unmet needs ≥ 10 years post-diagnosis. Identifying patient characteristics that predict long-term unmet needs may help to identify targeted interventions.