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Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer

  1. Nancy K. Janz PhD1,†,*,
  2. Sarah T. Hawley PhD, MPH2,3,
  3. Mahasin S. Mujahid PhD4,
  4. Jennifer J. Griggs MD, MPH3,
  5. Amy Alderman MD, MPH5,
  6. Ann S. Hamilton PhD6,
  7. John J. Graff PhD7,
  8. Reshma Jagsi MD, DPhil8,
  9. Steven J. Katz MD, MPH2,3,9

Article first published online: 28 MAR 2011

DOI: 10.1002/cncr.25740

Issue

Cancer

Cancer

Volume 117, Issue 9, pages 1827–1836, 1 May 2011

Additional Information

How to Cite

Janz, N. K., Hawley, S. T., Mujahid, M. S., Griggs, J. J., Alderman, A., Hamilton, A. S., Graff, J. J., Jagsi, R. and Katz, S. J. (2011), Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer. Cancer, 117: 1827–1836. doi: 10.1002/cncr.25740

Author Information

  1. 1

    Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan

  2. 2

    Veterans Administration Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan

  3. 3

    Division of General Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan

  4. 4

    Division of Epidemiology, University of California Berkeley, School of Public Health, Berkeley, California

  5. 5

    Department of Surgery, University of Michigan, Ann Arbor, Michigan

  6. 6

    Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California

  7. 7

    Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey

  8. 8

    Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

  9. 9

    Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan

  1. †

    Fax: (734) 763-9115

*UM School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029

Publication History

  1. Issue published online: 19 APR 2011
  2. Article first published online: 28 MAR 2011
  3. Manuscript Accepted: 27 SEP 2010
  4. Manuscript Revised: 9 SEP 2010
  5. Manuscript Received: 29 JUN 2010

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Keywords:

  • breast cancer;
  • recurrence;
  • quality of life;
  • minority health;
  • health status disparities;
  • quality of healthcare

Abstract

BACKGROUND:

Worry about recurrence (worry) is a persistent concern of breast cancer survivors. Little is known about whether race/ethnicity or healthcare experiences are associated with worry.

METHODS:

Women with nonmetastatic breast cancer diagnosed from June 2005 to February 2007 and reported to Detroit or Los Angeles Surveillance, Epidemiology, and End Results registries were surveyed (mean 9 months postdiagnosis); 2290 responded (73%). Latinas and African Americans were oversampled. A worry scale was constructed as the mean score of 3 items (on 5-point Likert, higher = more worry): worry about cancer returning to the same breast, occurring in the other breast, or spreading to other parts of the body. Race/ethnicity categories were white, African American, and Latina (categorized into low vs high acculturation). The worry scale was regressed on sociodemographics, clinical/treatment, and healthcare experience factors (eg, care coordination collapsed into low, medium, high).

RESULTS:

Low acculturated Latinas reported more worry and African Americans less worry than whites (P < .001). Other factors independently associated with more worry were younger age, being employed, more pain and fatigue, and radiation (Ps < .05). With all factors in the model, less worry was associated (all Ps < .05) with greater ease of understanding information (2.89, 2.99, 2.81 for low, medium, high), better symptom management (3.19, 2.89, 2.87 for low, medium, high), and more coordinated care (3.36, 2.94, 2.82 for low, medium, high). Race/ethnicity remained significant controlling for all factors (P < .001).

CONCLUSIONS:

Less acculturated Latina breast cancer patients are vulnerable to high levels of worry. Interventions that improve information exchange, symptom management, and coordinating care hold promise in reducing worry. Cancer 2011. © 2011 American Cancer Society.

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