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      Disparities in the survivorship experience among Latina survivors of breast cancer : Latina Breast Cancer Survivorship Disparity

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d383462e209">Purpose</h5> <p id="P1">We investigated disparities in the survivorship experience among Latinas with breast cancer (BC) in comparison with non-Latinas. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d383462e214">Methods</h5> <p id="P2">A cross-sectional bilingual telephone survey was conducted among 212 Latina and non-Latina women within 10-24 months after diagnosis of breast cancer (Stage 0-III) at two Los Angeles County public hospitals. Data were collected using Preparing for Life as a (New) Survivor (PLANS) Scale, Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI), Breast Cancer Prevention Trial (BCPT) Symptom Checklist, Satisfaction with Care and Information Scale, Consumer Assessment of Healthcare Providers and Systems <i>(CAHPS)</i> tool, Charlson Comorbidity Index adapted for patient self-report, and the 12-item Short Form Health Survey. Controlling variables included age, education, and study site in multivariate analyses. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d383462e222">Results</h5> <p id="P3">The mean ages of Latinas and non-Latinas were 51.5 and 56.6 years respectively. Compared to non-Latinas, Latinas reported less BC survivorship knowledge (27.3 vs 30.7, P&lt;.0001); were more dissatisfied with BC care information (2.3 vs 3.4, P&lt;.0001); reported lower PEPPI scores (38.2 vs 42.2, P=0.03) and experienced more BCPT symptoms (6.4 vs 5.0, P=0.04). No differences existed regarding their confidence in survivorship care preparedness (42.7 vs 41, P=0.191), satisfaction with BC survivorship care (9.6 vs 8.8, P=0.298) or their discussion with physicians (9.6 vs 8.1, p=0.07). These ethnic group differences persisted in multivariate analyses, except for PEPPI. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d383462e227">Conclusions</h5> <p id="P4">Latina BC survivors experienced disparities in BC knowledge and satisfaction with information received, but felt as prepared for survivorship, and satisfied with providers, care received and discussions with physicians as did non-Latinas. </p> </div>

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          Most cited references47

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          Patient satisfaction: A review of issues and concepts

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            Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.

            During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship. We investigated the baseline psychosocial status of women enrolled in a randomized trial testing two psychosocial interventions for women at the end of primary treatment. Participants, identified within 1 month after surgery (registration), provided demographic information and limited measures of quality of life. They were followed until they finished primary treatment (enrollment), at which time they completed a mailed baseline survey that included standardized measures of quality of life (including standardized scales of physical and emotional functioning), mood, symptoms, and sexual functioning. A total of 558 patients (mean age = 56.9 years) were enrolled in the study between July 1, 1999, and June 30, 2002. Health outcomes were examined according to treatment received: mastectomy with and without chemotherapy, and lumpectomy with and without chemotherapy. All statistical tests were two-sided. Among all treatment groups, patients who had a mastectomy had the poorest physical functioning at registration (P<.001) and at enrollment (P=.05). At enrollment, mood and emotional functioning were similar among all patients, with no differences by type of treatment received. At enrollment, symptoms, including muscle stiffness, breast sensitivity, aches and pains, tendency to take naps, and difficulty concentrating, were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery (P<.001). At the end of primary treatment for breast cancer, women in all treatment groups report good emotional functioning but report decreased physical functioning, particularly among women who have a mastectomy or receive chemotherapy. Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer.
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              Disparities in breast cancer characteristics and outcomes by race/ethnicity.

              Disparities in breast cancer stage and mortality by race/ethnicity in the United States are persistent and well known. However, few studies have assessed differences across racial/ethnic subgroups of women broadly defined as Hispanic, Asian, or Pacific Islander, particularly using more recent data. Using data from 17 population-based cancer registries in the Surveillance, Epidemiology, and End Results (SEER) program, we evaluated the relationships between race/ethnicity and breast cancer stage, hormone receptor status, treatment, and mortality. The cohort consisted of 229,594 women 40-79 years of age diagnosed with invasive breast carcinoma between January 2000 and December 2006, including 176,094 non-Hispanic whites, 20,486 Blacks, 15,835 Hispanic whites, 14,951 Asians, 1,224 Pacific Islanders, and 1,004 American Indians/Alaska Natives. With respect to statistically significant findings, American Indian/Alaska Native, Asian Indian/Pakistani, Black, Filipino, Hawaiian, Mexican, Puerto Rican, and Samoan women had 1.3-7.1-fold higher odds of presenting with stage IV breast cancer compared to non-Hispanic white women. Almost all groups were more likely to be diagnosed with estrogen receptor-negative/progesterone receptor-negative (ER-/PR-) disease with Black and Puerto Rican women having the highest odds ratios (2.4 and 1.9-fold increases, respectively) compared to non-Hispanic whites. Lastly, Black, Hawaiian, Puerto Rican, and Samoan patients had 1.5-1.8-fold elevated risks of breast cancer-specific mortality. Breast cancer disparities persist by race/ethnicity, though there is substantial variation within subgroups of women broadly defined as Hispanic or Asian. Targeted, multi-pronged interventions that are culturally appropriate may be important means of reducing the magnitudes of these disparities.
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                Author and article information

                Journal
                Cancer
                Cancer
                Wiley
                0008543X
                June 01 2018
                June 01 2018
                April 06 2018
                : 124
                : 11
                : 2373-2380
                Affiliations
                [1 ]Schulich Interfaculty Program in Public Health; Western University; London Ontario Canada
                [2 ]United Health Group, Cypress; California
                [3 ]Department of Medicine; David Geffen School of Medicine; Los Angeles California
                [4 ]James Stomber Consulting; San Francisco CA
                [5 ]Division of Hematology/Oncology, Department of Medicine, School of Medicine; University of Michigan; Ann Arbor Michigan
                [6 ]Division of Cancer Prevention and Control Research; University of California at Los Angeles Jonson Comprehensive Cancer Center; Los Angeles California
                [7 ]Department of Family Medicine; David Geffen School of Medicine at University of California at Los Angeles; Los Angeles California
                Article
                10.1002/cncr.31342
                5992041
                29624633
                e03f34e9-456c-4e80-8c24-cf6e3c26458a
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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