Influential factors in Black and White breast cancer survivors' beliefs about breast cancer.

Abstract

Breast cancer beliefs are widely studied to improve preventative screening behaviors in women without cancer; however, limited research has examined breast cancer beliefs among breast cancer survivors. To fill this gap in research we investigated racial differences and the predicting role of influential factors (e.g., stage) in survivors' beliefs about their breast cancer. This study is a secondary analysis of data from the Narrowing Gap in Adjuvant Therapy Study (2006-2011), where Black (N=210) and White women (N=149) were interviewed within 20 weeks following their breast cancer diagnosis and primary surgery in Washington DC and Detroit, MI. Outcomes of this analysis were perceived susceptibility to a breast cancer recurrence and perceived severity of breast cancer. Bivariate analyses were conducted to assess racial differences in sample characteristics, and on the study outcomes. Adjusted multiple regression models examined correlates between independent variables (e.g., sociodemographic/clinical) and women's breast cancer beliefs about susceptibility of a recurrence and disease severity. Most of the sample were Black women (58%), had breast-conserving surgery (64%), and were privately insured (67%). Black women reported higher perceived disease severity beliefs than White women (p=0.004). Other associated factors with greater perceived severity beliefs included lower education (p=0.008), public health insurance (p=0.021) and greater levels of medical mistrust (p=0.016). In our adjusted multiple regression models' women with lower satisfaction regarding financial aspects of their healthcare were more likely to have higher perceived severity beliefs (p=0.007); women with stage II cancer compared to stage I had greater susceptibility beliefs to a cancer recurrence (p=0.001). We found racial differences in women's perceived severity beliefs, and identified theory-based clinical and psychosocial correlates in survivor's breast cancer beliefs by race. Specifically, women diagnosed at stage (II) compared to stage (I) reported greater perceived susceptibility to a recurrence. Survivors diagnosed at stage (I) and (III) cancers may serve as important target groups to monitor their surveillance and follow-up behaviors. This study contributes salient predictors in survivors' beliefs about their BC and informs navigation strategies to improve cancer survivorship recommendations in the context of psycho-oncology and follow-up cancer care.