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Treatment experiences of Latinas after diagnosis of breast cancer

Authors

  • Steven J. Katz MD, MPH,

    Corresponding author
    1. Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan
    2. Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
    • Corresponding author: Steven J. Katz, MD, MPH, Department of Internal Medicine, School of Medicine, University of Michigan, North Campus, Research Complex, 2800 Plymouth Rd, B16 Rm 410E, Ann Arbor, MI 48109-2800; Fax: (734) 936-8944; skatz@med.umich.edu

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  • Lauren P. Wallner PhD, MPH,

    1. Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan
    2. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Paul H. Abrahamse MA,

    1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Nancy K. Janz PhD,

    1. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Kathryn A. Martinez PhD, MPH,

    1. Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio
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  • Dean A. Shumway MD,

    1. Department of Radiation Oncology, School of Medicine, University of Michigan, Ann Arbor, Michigan
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  • Ann S. Hamilton PhD,

    1. Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Kevin C. Ward PhD, MPH,

    1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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  • Kenneth A. Resnicow PhD,

    1. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Sarah T. Hawley PhD, MPH

    1. Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan
    2. Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
    3. Veterans Administration Center for Clinical Management Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan
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  • We acknowledge the work of our project staff (Mackenzie Crawford, MPH, and Kiyana Perrino, MPH, from the Georgia Cancer Registry; Jennifer Zelaya, Pamela Lee, Maria Gaeta, Virginia Parker, BA, and Renee Bickerstaff-Magee from the University of Southern California; and Rebecca Morrison, MPH, Alexandra Jeanpierre, MPH, Stefanie Goodell, BS, Irina Bondarenko, MS, and Rose Juhasz, PhD, from the University of Michigan). We acknowledge with gratitude our survey respondents.

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. © 2017 American Cancer Society.

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