Abstract 3560: Understanding health-seeking delays for post-menopausal bleeding among subpopulations of Black women
Authors: Maurice J. Chery, LaShea D. Rolle, Wilmar Belizaire, Alejandra Casas, Sara M. St. George, Sophia HL George, Matthew Schlumbrecht
Journal: Cancer Research (2025)

Abstract Background: Black women face disproportionate risks of endometrial cancer (EC). They more often present with advanced stage and high-grade histologies, and have lower survival rates compared to White women. Subpopulations of the Black community have been shown to have variable risks of disease and poor outcomes; the underlying causes for this observation are unknown. Without specific screening tests for EC, timely diagnosis relies on recognizing postmenopausal bleeding (PMB), the most common symptom. Our objective was to explore perceptions of PMB and factors influencing care-seeking behavior when PMB occurs among subpopulations of healthy Black women to determine if these factors influence observed intra-racial disparities. Methods: We utilized a community based participatory research approach guided by the Safer and Anderson model of Total Patient Delay. We conducted focus groups with three subpopulations of healthy Black women (US-born [USB], Caribbean-born English speaking [CBB], and Haitian-Creole speaking [HC]) who were ≥50 years old. We collected demographic information and queried participants about their perceptions of PMB if they were to personally experience it, including its meaning, disclosure of the symptoms to others, and strategies to self-appraise and engage the healthcare system. We transcribed, thematically coded, and analyzed each session using Dedoose software. Results: Fifty-four women (median age 60 [54-65]) participated (USB 40%; HC 40%, CBB 20%). Over 60% were non-USB, and 90% had at least a high school education. Cultural and religious beliefs significantly shaped health management across all groups. HC prioritized prayer and divine guidance over immediate medical care, preferring to use natural remedies aligned with traditional health practices. USB integrated spiritual beliefs with conventional medical approaches but expressed concerns over stigma, leading to selective sharing of health concerns within families. CBB highlighted hereditary factors, linking PMB symptoms to family history and genetics. Across all groups, family dynamics shaped health-seeking behaviors, with non-USB preferring to rely more heavily on familial networks for guidance. Information-seeking behaviors varied, from strong reliance on digital resources (USB) to direct validation from healthcare professionals (CBB) or community networks (HC). Despite differences, all groups highlighted delays in seeking care, often attributed to symptom misconceptions and normalization of PMB. Conclusion: In the hypothetical setting of PMB, cultural beliefs, familial dynamics, and information-seeking behaviors shape health perceptions and care-seeking actions among Black women. Culturally tailored interventions to address knowledge gaps, promote timely recognition of PMB, and encourage early engagement with healthcare providers are needed to reduce EC disparities. Citation Format: Maurice J. Chery, LaShea D. Rolle, Wilmar Belizaire, Alejandra Casas, Sara M. St. George, Sophia HL George, Matthew Schlumbrecht. Understanding health-seeking delays for post-menopausal bleeding among subpopulations of Black women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3560.