Treatment experiences of Latinas after diagnosis of breast cancer

• Type of Material: Article
• Authors: Steven J. Katz, University of Michigan Medical School; Lauren P. Wallner, University of Michigan Medical School; Paul H. Abrahamse, University of Michigan School of Public Health; Nancy K. Janz, University of Michigan School of Public Health; Kathryn A. Martinez, Cleveland Clinic Foundation; Dean A. Shumway, University of Michigan Medical School; Ann S. Hamilton, Keck School of Medicine of USC; Kevin C. Ward, Emory University; Kenneth A. Resnicow, University of Michigan School of Public Health; Sarah T. Hawley, University of Michigan Medical School
• Language: English
• Date: 2017-08-15
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Cancer Society
• Final Published Version (URL): http://dx.doi.org/10.1002/cncr.30702
• Title of Journal or Parent Work: Cancer
• ISSN: 0008-543X
• Volume: 123
• Issue: 16
• Start Page: 3022
• End Page: 3030
• Grant/Funding Information: Cancer incidence data collection was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/DP003862; the NCI’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California (USC), and contract HHSN261201000034C awarded to the Public Health Institute.; This work was funded by grant P01CA163233 to the University of Michigan from the National Cancer Institute.; Cancer incidence data collection in Georgia was supported by contract HHSN261201300015I, Task Order HHSN26100006 from the NCI and cooperative agreement 5NU58DP003875-04-00 from the CDC.
• Keywords: Personal Autonomy; Surveillance, Epidemiology, and End Results (SEER) epidemiology studies; Los Angeles; treatment communication and decision making; Mastectomy; European Continental Ancestry Group; Radiotherapy, Adjuvant; Chemotherapy, Adjuvant; Health Literacy; Latina health; Physician-Patient Relations; Attitude to Health; Patient Satisfaction; Mastectomy, Segmental; Adult; Acculturation; breast cancer; Aged; Surgeons; Breast Neoplasms; Decision Making; African Americans; Young Adult; women's health; Hispanic Americans; Communication; Humans; Healthcare Disparities; Middle Aged; Oncologists; population-based observational studies; Asian Americans; Female
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology; Health Sciences, Epidemiology

Abstract

BACKGROUND: The authors examined racial/ethnic differences in patient perspectives regarding their breast cancer treatment experiences. METHODS: A weighted random sample of women newly diagnosed with breast cancer between 2013 and 2015 in Los Angeles County and Georgia were sent surveys 2 months after undergoing surgery (5080 women; 70% response rate). The analytic sample was limited to patients residing in Los Angeles County (2397 women). RESULTS: The pattern of visits with different specialists before surgery was found to be similar across racial/ethnic groups. Low acculturated Latinas (Latinas-LA) were less likely to report high clinician communication quality for both surgeons and medical oncologists (<69% vs >72% for all other groups; P<.05). The percentage of patients who reported high satisfaction regarding how physicians worked together was similar across racial/ethnic groups. Latinas-LA were more likely to have a low autonomy decision style (48% vs 24%-50% for all other groups; P<.001) and were more likely to report receiving too much information versus other ethnic groups (20% vs <16% for other groups; P<.001). Patients who reported a low autonomy decision style were more likely to rate the amount of information they received for the surgery decision as “too much” (16% vs 9%; P<.001). CONCLUSIONS: There appears to be moderate disparity in breast cancer treatment communication and decision-making experiences reported by Latinas-LA versus other groups. The approach to treatment decision making by Latinas-LA represents an important challenge to health care providers. Initiatives are needed to improve patient engagement in decision making and increase clinician awareness of these challenges in this patient population. Cancer 2017;123:3022–30.