We acknowledge Ana Guerrero for assistance with interviews and Huichuan Lii for her programming expertise. We also acknowledge all of the women who participated in the survey.
Racial/ethnic disparities in knowledge about one's breast cancer characteristics
Version of Record online: 26 JAN 2015
© 2015 American Cancer Society
Volume 121, Issue 5, pages 724–732, March 1, 2015
How to Cite
Freedman, R. A., Kouri, E. M., West, D. W. and Keating, N. L. (2015), Racial/ethnic disparities in knowledge about one's breast cancer characteristics. Cancer, 121: 724–732. doi: 10.1002/cncr.28977
The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California, the Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be concluded.
- Issue online: 19 FEB 2015
- Version of Record online: 26 JAN 2015
- Manuscript Accepted: 25 JUL 2014
- Manuscript Revised: 17 JUL 2014
- Manuscript Received: 26 JUN 2014
- breast cancer;
- health literacy;
Understanding tumor characteristics is likely important, but little is known about breast cancer patients' knowledge of their own disease. The authors assessed women's knowledge about their tumor characteristics, whether racial/ethnic disparities in knowledge exist, and whether education and health literacy influence associations.
A population-based cohort of women in Northern California with stage 0 through III breast cancers diagnosed from 2010 to 2011 (participation rate 68.5%) was surveyed. Among 500 respondents (222 non-Hispanic white women, 142 non-Hispanic black women, and 136 Hispanic women), racial/ethnic differences in knowledge about tumor characteristics (estrogen receptor [ER] status, human epidermal growth factor receptor 2 [HER2] status, stage, grade) and correctness of tumor information (with California Cancer Registry data for confirmation) were examined. Multivariate logistic regression was used to assess the probability of: 1) knowing tumor stage, receptor status, and grade; and 2) correctly answering questions about tumor information by race/ethnicity. The impact of education and health literacy on findings was examined in sequential models.
Overall, 32% to 82% of women reported knowing each of the 4 tumor characteristics of interest, and 20% to 58% correctly reported these characteristics. After adjustment, black and Hispanic women were less likely than white women to know and have correct responses for stage, ER status, and HER2 status (all P<.05). Education and health literacy were significantly associated with knowing and having correct information about some characteristics, but these variables did not eliminate most of the racial/ethnic differences observed.
Patient's knowledge about their own breast cancer was generally poor, particularly for minority women. Further study of how this knowledge may impact receipt of care and outcomes is warranted. Cancer 2015;121:724–732. © 2014 American Cancer Society.