Black And Spanish-Speaking Hispanic Women More Likely Than White Women To Show Dissatisfaction, Regret About Breast Cancer Treatment Decision Process

Main Category: Breast Cancer
Also Included In: Public Health
Article Date: 06 Nov 2008 - 9:00 PDT

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Black and Hispanic women, particularly Hispanic women who prefer to speak Spanish, are more likely than white women to be dissatisfied or regret decisions made about their breast cancer treatment, according to a study by University of Michigan researchers, Reuters Health reports.

Women with breast cancer vary in their preferences for how to make decisions about their treatment, with some preferring to play a larger role in deciding whether to have a mastectomy or lumpectomy and others preferring to have a smaller role in the decision. Study author Sarah Hawley said that a "mismatch" between a woman's preferences and the treatment decision has been linked with a poorer quality of life later on.

To examine whether perspectives about treatment decisions varied by ethnicity, Hawley and her colleagues surveyed 2,030 women who were diagnosed with early-stage breast cancer. Of the 877 women who responded, 24.5% were Hispanic women who preferred to speak Spanish, 20.5% were Hispanic women who preferred to speak English, 24% were black and 26.6% were white. Among the women:

• About 28% said their surgeon played a significant role in deciding which procedure to undergo;
  
  
• 36% said they played a role in the decision along with the surgeon; and
  
  
• 36% said they made the decisions on their own.

When looking at women's satisfaction with the decisions, Spanish-speaking Hispanic women were 5.5 times more likely to be dissatisfied with the decision-making process than whites and 4.1 times more likely to regret the decision that was made. English-speaking Hispanic women were about 2.6 times more likely than whites to be dissatisfied, and twice as likely to regret the decision. Black women were about twice as likely as whites to be dissatisfied or regretful.

The study did not examine reasons for the findings, but Hawley suggested that Spanish-speaking Hispanic women might have wanted their families to be more involved in the decision-making process or might have had some other cultural concerns that were not addressed. Hawley said, "Unfortunately it wasn't terribly surprising that less acculturated Latinas were not as satisfied with their interaction with the health care system."

Researchers noted, "These results ... suggest that additional effort may be needed by clinicians to ensure that information is understandable and culturally appropriate and improve the decision making for all breast cancer patients" (Harding, Reuters Health, 11/4).

An abstract of the study is available online.

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