The excess burden of breast carcinoma in minority and medically underserved communities

Shinagawa, Susan Matsuko

doi:10.1002/(sici)1097-0142(20000301)88:5+<1217::aid-cncr7>3.0.co;2-k

Cited by 54 publications

(39 citation statements)

References 26 publications

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al, 1996;Ries et al, 2000;Shinagawa, 2000).In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000).…”

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Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors

et al. 2003

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Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds.We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. selfsacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors *Correspondence to: UCLA, Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Box 62, Los Angeles, CA, USA. E-mail: kashing@ucla.edu. NIH Public Access Author ManuscriptPsychooncology. Author manuscript; available in PMC 2006 October 20. Published in final edited form as:Psychooncology. 2004 June ; 13(6): 408-428. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship.Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greate...

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

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confidence: 99%

Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors

et al. 2003

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“…[17][18][19] While these data are encouraging, they primarily reflect the management of women with an average risk of developing breast cancer. Women considered at higher risk for developing breast cancer than the general population, however, may be candidates for more intensive screening and interventions for primary prevention.…”

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Race and family history assessment for breast cancer

et al. 2005

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OBJECTIVE: Studies have demonstrated disparities in breast cancer screening between racial and ethnic groups. Knowledge of a woman's family history of breast cancer is important for initiating early screening interventions. The purpose of this study was to determine whether differences exist in the collection of family history information based on patient race. DESIGN:Cross-sectional patient telephone interview and medical record review.SETTING: Eleven primary care practices in the Greater Boston area, all associated with Harvard Medical School teaching hospitals. PARTICIPANTS:One thousand seven hundred fifty-nine women without a prior history of breast cancer who had been seen at least once by their primary care provider during the prior year. MEASUREMENTS AND MAIN RESULTS:Data were collected on patients regarding self-reported race, family breast cancer history information, and breast cancer screening interventions. Twenty-six percent (462/1,759) of the sample had documentation within their medical record of a family history for breast cancer. On multivariate analysis, after adjusting for patient age, education, number of continuous years in the provider's practice, language, and presentation with a breast complaint, white women were more likely to be asked about a breast cancer family history when compared to nonwhite women (odds ratio, 1.68; 95% confidence interval, 1.21 to 2.35). CONCLUSIONS:The majority of women seen by primary care providers do not have documentation of a family breast cancer history assessment within their medical record. White women were more likely to have family breast cancer information documented than nonwhites.

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“…Other groups, such as Hispanics, Filipinos, Native Americans, Chinese, and Koreans, also tend to present with a more advanced disease [4]. Extensive studies have shown that socioeconomic and environmental factors, as well as age at diagnosis, screening differences, and access to care, are important in these disparities [2,[5][6][7]. For example, more advanced disease at presentation could be due to differences in access to medical care or in screening practices [8].…”

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The interleukin-6 gene: a susceptibility factor that may contribute to racial and ethnic disparities in breast cancer mortality

Berger

2004

Breast Cancer Res Treat

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Breast cancer prognosis differs among racial and ethnic groups. Though the incidence of breast cancer is lower in African-Americans than in Caucasians, mortality is higher. While socioeconomic, psychosocial, and lifestyle issues are undoubtedly important in such disparities, genetic factors that differ among populations and that are involved in the molecular pathways regulating tumor development may also play roles. In this communication, I summarize recent investigations of the gene encoding the pro-inflammatory cytokine interleukin-6 (IL-6), and suggest that this gene is a susceptibility factor that determines racial and/or ethnic differences in breast cancer survival. Published studies of a G/C polymorphism at nucleotide -174 within the promoter region of the IL-6 gene are consistent with this suggestion. This polymorphism alters expression of the cytokine. In addition, allele and genotype frequencies at the -174 site differ dramatically among racial and ethnic groups. Finally, the variant genotypes are associated with alterations in breast cancer survival. In all, these observations argue for additional studies of the IL-6 gene polymorphism as a predisposing genetic factor that contributes to racial and ethnic differences in breast cancer prognosis.

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The excess burden of breast carcinoma in minority and medically underserved communities

Cited by 54 publications

References 26 publications

Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors

Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors

Race and family history assessment for breast cancer

The interleukin-6 gene: a susceptibility factor that may contribute to racial and ethnic disparities in breast cancer mortality

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