A Systematic Review of Interpersonal Interactions Related to Racism in Studies Assessing Breast and Gynecological Cancer Health Outcomes Among Black Women

Hirschey, Rachel; Xu, Jingle; Ericson, Kathryn; Burse, Natasha Renee; Bankole, Ayomide Okanlawon; Conklin, Jamie L.; Bryant, Ashley Leak

doi:10.1007/s40615-023-01769-1

J. Racial and Ethnic Health Disparities

2023

DOI: 10.1007/s40615-023-01769-1

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A Systematic Review of Interpersonal Interactions Related to Racism in Studies Assessing Breast and Gynecological Cancer Health Outcomes Among Black Women

Rachel Hirschey,

Jingle Xu,

Kathryn Ericson

et al.

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Post-diagnosis weight trajectories and mortality among women with breast cancer

Puklin,

Li,

Cartmel

et al. 2023

npj Breast Cancer

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Weight gain after breast cancer diagnosis is associated with adverse health outcomes. Yet, few studies have characterized post-diagnosis weight change in the modern treatment era or populations most at risk for weight changes. Among women diagnosed with stages I–III breast cancer in the Smilow Care Network (2013–2019; N = 5441), we abstracted demographic and clinical characteristics from electronic health records and survival data from tumor registries. We assessed if baseline characteristics modified weight trajectories with nonlinear multilevel mixed-effect models. We evaluated body mass index (BMI) at diagnosis and weight change 1-year post-diagnosis in relation to all-cause and breast cancer-specific mortality with Cox proportional hazard models. Women had 34.4 ± 25.5 weight measurements over 3.2 ± 1.8 years of follow-up. Weight gain was associated with ER/PR−, HER2+ tumors, BMI ≤ 18.5 kg/m2, and age ≤ 45 years (+4.90 kg (standard error [SE] = 0.59), +3.24 kg (SE = 0.34), and +1.75 kg (SE = 0.10), respectively). Weight loss was associated with BMI ≥ 35 kg/m2 and age ≥ 70 years (−4.50 kg (SE = 0.08) and −4.34 kg (SE = 0.08), respectively). Large weight loss (≥10%), moderate weight loss (5–10%), and moderate weight gain (5–10%) 1-year after diagnosis were associated with higher all-cause mortality (hazard ratio [HR] = 2.93, 95% confidence interval [CI] = 2.28–3.75, HR = 1.32, 95% CI = 1.02–1.70 and HR = 1.39, 95% CI = 1.04–1.85, respectively). BMI ≥ 35 kg/m2 or BMI ≤ 18.5 kg/m2 at diagnosis were also associated with higher all-cause mortality. Weight change after a breast cancer diagnosis differed by demographic and clinical characteristics highlighting subgroups at-risk for weight change during a 5-year period post-diagnosis. Monitoring and interventions for weight management early in clinical care are important.

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Post-diagnosis weight trajectories and mortality among women with breast cancer

Puklin,

Li,

Cartmel

et al. 2023

npj Breast Cancer

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Racial discrimination and health-care system trust among American adults with and without cancer

Brown,

Taffe,

Richmond

et al. 2024

JNCI: Journal of the National Cancer Institute

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Background Racial and ethnic minoritized groups report disproportionately lower trust in the healthcare system. Lower healthcare system trust is potentially related to increased exposure to racial discrimination in medical settings, but this association is not fully understood. We examined the association between racial discrimination in medical care and trust in the healthcare system among people with and without a personal cancer history. Methods We examined racial discrimination and trust in a nationally representative American adult sample from the Health Information National Trends Survey 6. Racial discrimination was defined as any unfair treatment in healthcare based on race or ethnicity. Trust in the healthcare system (eg, hospitals and pharmacies) was grouped into low, moderate, and high trust. Multinomial logistic regression models were used to compare low and moderate trust relative to high trust in the healthcare system and estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 5,813 respondents (15% with a personal cancer history) were included 92% (n = 5,355) reported no prior racial discrimination experience during medical treatment. Prior experiences of racial discrimination were positively associated with low (OR = 6.12, 95% CI: 4.22-8.86) and moderate (OR = 2.70, 95% CI: 1.96-3.72) trust in the healthcare system, relative to high trust. Similar associations were observed when stratifying by personal cancer history. Conclusion Respondents who reported racial discrimination during medical encounters had lower trust in the healthcare system, especially respondents with a personal cancer history. Our findings highlight the need to address racial discrimination experiences during medical care to build patient trust and promote healthcare access.

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A Systematic Review of Interpersonal Interactions Related to Racism in Studies Assessing Breast and Gynecological Cancer Health Outcomes Among Black Women

Cited by 2 publications

References 47 publications

Post-diagnosis weight trajectories and mortality among women with breast cancer

Post-diagnosis weight trajectories and mortality among women with breast cancer

Racial discrimination and health-care system trust among American adults with and without cancer

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