Disparities in barriers to follow-up care between African American and White breast cancer survivors

被引:43
作者
Palmer, Nynikka R. A. [1 ]
Weaver, Kathryn E. [2 ]
Hauser, Sally P. [3 ]
Lawrence, Julia A. [3 ]
Talton, Jennifer [4 ]
Case, L. Douglas [4 ]
Geiger, Ann M. [5 ]
机构
[1] Univ Calif San Francisco, San Francisco Gen Hosp, Div Gen Internal Med, San Francisco, CA 94143 USA
[2] Wake Forest Sch Med, Div Publ Hlth Sci, Social Sci & Hlth Policy, Winston Salem, NC USA
[3] Wake Forest Comprehens Canc Ctr, Gen Surg, Winston Salem, NC USA
[4] Wake Forest Sch Med, Div Publ Hlth Sci, Biostat Sci, Winston Salem, NC USA
[5] NCI, Hlth Serv & Econ Branch, Appl Res Program, Div Canc Control & Populat Sci, Rockville, MD USA
基金
美国国家卫生研究院;
关键词
Barriers; Follow-up care; Health disparities; Cancer survivor; Breast cancer; UNITED-STATES; NONCANCER CONTROLS; MEDICAL-CARE; PATIENT; SURVEILLANCE; METAANALYSIS; DIAGNOSIS; SUPPORT; ACCESS; SYSTEM;
D O I
10.1007/s00520-015-2706-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009-2011, 6-24 months post-treatment (N = 203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62 %. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28 vs. 51.6 %, p = 0.01), other health care costs (21.3 vs. 45.2 %, p = 0.01), anxiety/worry (29.4 vs. 51.6 %, p = 0.02), and transportation (4.4 vs. 16.1 %, p = 0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (odds ratio (OR) = 3.3, 95 % confidence interval (CI) = 1.1-10.1). Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors.
引用
收藏
页码:3201 / 3209
页数:9
相关论文
共 42 条
[1]   Ethnic Disparities in Adherence to Breast Cancer Survivorship Surveillance Care [J].
Advani, Pragati S. ;
Ying, Jun ;
Theriault, Richard ;
Melhem-Bertrand, Amal ;
Moulder, Stacy ;
Bedrosian, Isabelle ;
Tereffe, Welela ;
Black, Shon ;
Pini, Tunghi May ;
Brewster, Abenaa M. .
CANCER, 2014, 120 (06) :894-900
[2]  
[Anonymous], FOLLOW UP CAR US SUR
[3]  
[Anonymous], 2014, NCCN Clinical Practice Guidelines in Oncology: Survivorship
[4]  
[Anonymous], 2012, CANC TREATM SURV FAC
[5]  
[Anonymous], 2013, CANC FACTS FIG AFR A
[6]  
[Anonymous], Behavioral Risk Factor Surveillance System
[7]   Response rates to mail surveys published in medical journals [J].
Asch, DA ;
Jedrziewski, MK ;
Christakis, NA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1997, 50 (10) :1129-1136
[8]   Are survivorship care plans responsive to African-American breast cancer survivors?: voices of survivors and advocates [J].
Ashing-Giwa, Kimlin ;
Tapp, Carolyn ;
Brown, Shirley ;
Fulcher, Gingi ;
Smith, June ;
Mitchell, Eudora ;
Santifer, Rhonda H. ;
McDowell, Kommah ;
Martin, Virginia ;
Betts-Turner, Betty ;
Carter, DeBorrah ;
Rosales, Monica ;
Jackson, Paris Adkins .
JOURNAL OF CANCER SURVIVORSHIP, 2013, 7 (03) :283-291
[9]   Peer-Based Models of Supportive Care: The Impact of Peer Support Groups in African American Breast Cancer Survivors [J].
Ashing-Giwa, Kimlin ;
Tapp, Carolyn ;
Rosales, Monica ;
McDowell, Kommah ;
Martin, Virginia ;
Santifer, Rhonda Holbert ;
Clark, Phyllis ;
Steward, Joy ;
Lewis, Leah ;
Mitchell, Eudora .
ONCOLOGY NURSING FORUM, 2012, 39 (06) :585-591
[10]   Adult cancer survivors: How are they faring? [J].
Baker, F ;
Denniston, M ;
Smith, T ;
West, MM .
CANCER, 2005, 104 (11) :2565-2576