62O_PR - Non-adherence to adjuvant endocrine treatment and its determinants among early stage breast cancer patients

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Breast cancer
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Early Stage
Presenter Wahyu Wulaningsih
Citation Annals of Oncology (2016) 27 (suppl_9): ix19-ix29. 10.1093/annonc/mdw575
Authors W. Wulaningsih1, H. Garmo2, J. Ahlgren3, L. Holmberg2, M. van Hemelrijck2, M. Lambe4
  • 1Mrc Unit For Lifelong Health And Ageing, UCL - University College London, WC1B 5JU - London/GB
  • 2Division Of Cancer Studies, King's College London Guy's Hospital, SE1 9RT - London/GB
  • 3Department Of Oncology, Universitetssjukhuset Orebro, 701 85 - Orebro/SE
  • 4Department Of Medical Epidemiology And Biostatistics, Karolinska Intitutet, 171 77 - Stockholm/SE



Non-adherence to adjuvant endocrine treatment (ET) among breast cancer patients has been associated with worse prognosis. We sought to identify factors affecting non-adherence to ET, taking into account determinants at baseline and follow-up.


From linkage between Swedish national registers, we identified all women diagnosed with stage I-III, ER-positive breast cancer in Stockholm-Gotland, Uppsala-Örebro and Northern Sweden between 2006 and 2009. A total of 4,413 women who had at least one dispensation of tamoxifen or aromatase inhibitors (AIs) and 5 years of follow-up were included in the analysis. A medical possession ratio (MPR) of 


During follow-up, 1,131 (25.6%) women became non-adherents. The following determinants of non-adherence were identified: age, marital status, region of diagnosis, private hospital, tumour size, lymph node metastasis, tumour grade, HER2 status, type of surgery, adjuvant chemotherapy, type of ET, pre-diagnostic hormone replacement therapy, the use of symptom-relieving drugs at baseline and during follow-up, baseline scores and any increase in Charlson co-morbidity index (CCI). In multivariable analysis, non-adherence was only associated with younger age (OR: 0.67; 95%CI: 0.50-0.90 and 0.66; 0.48-0.92 for age 50-65 and 65+ compared to 


Our study identifies socioeconomic subgroups with increased risk of non-adherence that may be of use when measures for improving adherence are tested. Women with pre-diagnostic use of HRT may represent a biological subset with a disposition for side effects from ET.

Clinical trial indentification

Legal entity responsible for the study

King\'s College London


King\'s College London


All authors have declared no conflicts of interest.