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 Anticancer Agents
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.