Abstract B42: Examining factors associated with high levels of breast cancer beliefs among Hispanic women.

Purpose: Certain cultural beliefs related to breast cancer may act as a barrier to a woman seeking breast cancer preventive services or timely follow-up for a breast symptom. In the Breast Cancer Care in Chicago study, Hispanic patients held considerably more cultural beliefs compared to African-American or non-Hispanic White patients. For Hispanics, holding beliefs that are inconsistent with health care seeking behavior may lead to low or delayed utilization of care regardless of access. This study explores factors associated with breast cancer beliefs among Hispanic women and how this might impact their screening and health seeking behavior. Methods: Data were obtained from a population-based sample of 181 urban Hispanic women recruited as part of the Breast Cancer Care in Chicago study. Women were ages 30-79 and had been diagnosed with primary in situ or invasive breast cancer. Interviews included a 15 item cultural beliefs scale spanning a range of beliefs regarding the meaning of a breast lump, importance of treatment, and the role of faith – beliefs that could be inconsistent with motivation to seek timely health care (inter-item correlation = 0.82). We dichotomized the total number of beliefs at the sample median, such that patients holding 3 or more beliefs (index) were compared to patients holding fewer than 3 beliefs (referent). Potential sociodemographic predictors were examined, as were census tract measures of cultural isolation, disadvantage and affluence. Prolonged presentation delay and prolonged clinical delay were each defined as delay exceeding the sample median (77 and 90 days, respectively) from symptom awareness to first clinical visit and from first clinical visit to first treatment for breast cancer, respectively. Results: Overall, 44% of the women in the sample held three or more beliefs related to breast cancer. The beliefs most commonly held were: 1) Faith in God can protect you from breast cancer (48%), 2) If a breast lump is touched or pressed often, the lump will turn out to be breast cancer (30%), and 3) If breast cancer is cut open in surgery, it will grow faster (28%). Lower socioeconomic status and lower levels of acculturation were associated with greater beliefs. Patients with less income and education and lacking private health insurance tended to hold more beliefs. Women who were older, born outside the U.S., did not speak English as a primary language, or whose parents were less educated or born outside the U.S., were more likely to hold higher levels of beliefs (p<0.05). Contrary to expectation, census tract measures of cultural isolation, disadvantage and affluence were not associated with beliefs. Possessing a greater number of beliefs was associated with delays in seeking and receiving health care for breast cancer. Prolonged presentation delay was more common among patients with greater number of beliefs than with fewer beliefs (41% vs. 17%, p=0.008). Likewise, prolonged clinical delay was more common for women holding a greater number of beliefs vs. fewer beliefs (41% vs. 24%, p=0.045). Conclusions: Cultural beliefs may predispose certain Hispanic women who are less acculturated and of lower socioeconomic status to delay seeking health care for breast cancer related symptoms. Citation Format: Rani I. Gallardo, Garth H. Rauscher, Carol E. Ferrans. Examining factors associated with high levels of breast cancer beliefs among Hispanic women. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B42.