Tuesday, November 18, 2008
The findings are based on feedback gathered during focus groups that included 29 low-income African-American women who were at least 40 years old. The women were asked about their perception of mammograms, whether they would undergo one to screen for breast cancer, and other related questions.
Despite recommendations for women 40 and older to have annual mammograms, only 55 percent of the women reported having a mammogram within the last two years. One woman in the study had a history of breast cancer.
Participants in the study were low-income, medically underserved African-American women who lived in urban, economically challenged neighborhoods throughout Chicago. Participants received a $15 gift certificate to a grocery store in exchange for their participation.
Asked why they did not go for regular mammograms, women in the study gave several reasons. Some felt they had not been treated with respect or not received adequate information from clinical teams during prior visits to health care facilities.
One woman recounted feeling uncomfortable when she was left alone while her images were being developed and read by a radiologist.
"You see, when they left me, there wasn't nobody with me to talk to me," she said.
Other study participants said they thought anyone with breast cancer would inevitably die from the disease, so there was no use getting a mammogram.
"I didn't know that it was a possibility to live after you had breast cancer or had been found having breast cancer," one woman said.
"Everybody I know who had breast cancer [has] died. I [wasn't aware] of anything different," another woman said.
Women also said that stories circulate of patients who had bad experiences undergoing mammograms and received incorrect cancer treatments, such as an unnecessary mastectomy. Those tales are all spun into the urban folklore about mammograms and impact women's decisions not to get screened. The study adds that because of their fears, some women delay getting screened, which leads to worse health outcomes such as late-stage cancer diagnosis and higher mortality rates.
The study points to the need for physicians to be trained in cultural sensitivity. If health care providers tailored their care appropriately for this population, these patients may be more likely to return for repeat mammograms. The study also suggests the need for more community-based health educators to work within underserved communities, explaining the breast cancer screening process, addressing misperceptions, and reinforcing the health messages women receive from their physicians.
"African-American women have a high need for comprehensive information and better communication from their health care providers on breast cancer prevention and treatment. Sadly, we heard none of the women in our study were aware of early diagnosis or positive breast cancer outcomes," Peek said. ###
The study was funded by the Open Society Institute's Medicine as a Profession (MAP) fellowship program and Susan G. Komen for the Cure. Peek is currently supported by the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development program.
Additional study authors include Judith Sayad and Ronald Markwardt.
Contact: Martha O'Connell Martha.OConnell@uchospitals.edu 773-834-8089
University of Chicago Medical Center
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