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Disparities in adherence to breast cancer care.

机译:对乳腺癌护理依从性的差异。

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摘要

Improvements in screening and treatment methods have resulted in a growing number of breast cancer survivors in the United States. Recognizing factors that influence breast cancer management practices among minority or immigrant women is as crucial as examining how these factors may differ within various racial/ethnic groups of populations.;The goal of this dissertation was to examine disparities (by both race/ethnicity and acculturation) in receipt of breast cancer management (both treatment and survivorship care). The specific aim of my first paper was to examine disparities by level of acculturation in the receipt of breast cancer treatment (type of surgery: mastectomy versus breast conserving surgery) and nonadherence to NCCN guidelines for breast cancer survivorship care among female Mexican American breast cancer patients receiving treatment at the MD Anderson Cancer Center and enrolled in the Ella Binational Breast Cancer Study. In the second study, we conducted a systematic review of literature to discuss and critique studies examining racial/ethnic disparities in the use of surveillance mammograms among breast cancer survivors.;Although, the association reached borderline level of statistical significance, we found that more acculturated women were less likely to receive a mastectomy (compared to breast conserving surgery) as their primary surgical treatment towards breast cancer. Additionally, these women had lower odds of nonadherence to survivorship care (both surveillance mammograms and clinic visits), although, this association was statistically non-significant. Our systematic review identified 22 unique studies that addressed racial and ethnic disparities in use of surveillance mammogram among breast cancer survivors. Overall, we found statistically significant racial/ethnic disparities in use of surveillance mammogram in thirteen (of 22) studies, with non-White women significantly less likely to receive timely surveillance mammogram compared to Whites for a majority of studies.;This research suggests that disparities in receipt of breast cancer care (both treatment and survivorship care) exist, not only by race/ethnicity but also by different levels of acculturation. Future interventions need to focus on providing better guidance to the minority & immigrant patients with their treatment related decisions, as well as improve patient retention in cancer survivorship care.
机译:筛查和治疗方法的改进导致美国乳腺癌幸存者的数量不断增加。认识到影响少数族裔或移民妇女乳腺癌管理实践的因素与研究这些因素在不同种族/族裔群体中的差异一样至关重要。本论文的目的是研究差异(通过种族/民族和适应度) )接受乳腺癌治疗(治疗和生存护理)。我的第一篇论文的具体目标是检查接受乳腺癌治疗的患者的适应程度差异(手术类型:乳房切除术还是保留乳房的手术)以及墨西哥裔美国女性乳腺癌患者不遵守NCCN乳腺癌幸存者护理指南在MD安德森癌症中心接受治疗,并参加了Ella Binational乳腺癌研究。在第二项研究中,我们对文献进行了系统的综述,以讨论和批评研究乳腺癌幸存者在使用乳腺X线照片中的种族/种族差异。;尽管该关联达到了统计学意义的临界水平,但我们发现其适应性更强女性对乳腺癌的主要手术治疗是较少接受乳房切除术(与保乳手术相比)。此外,尽管这些妇女在统计学上无统计学意义,但她们对幸存者不依从的几率较低(监测乳腺X线照片和诊所就诊)。我们的系统评价确定了22项独特的研究,这些研究针对乳腺癌幸存者在使用监测X线照片方面的种族和种族差异。总体而言,我们在13项(共22项)研究中发现,在使用监控乳腺X射线照片时,种族/族裔存在统计学差异,与大多数研究相比,非白人女性接受及时乳腺X射线摄影的可能性明显低于白人。乳腺癌护理(治疗和生存护理)的接受存在差异,不仅由于种族/民族,而且由于适应程度不同也存在差异。未来的干预措施应着重于为少数族裔和移民患者提供有关治疗决策的更好指导,以及改善患者在癌症生存护理中的保留率。

著录项

  • 作者

    Advani, Pragati.;

  • 作者单位

    The University of Texas School of Public Health.;

  • 授予单位 The University of Texas School of Public Health.;
  • 学科 Public health.;Epidemiology.
  • 学位 Dr.P.H.
  • 年度 2016
  • 页码 121 p.
  • 总页数 121
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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