title: Cancer-specific beliefs and survival: a population-based study of African-American and White breast cancer patients.
abstract: OBJECTIVE
  Beliefs about cancer and its treatment have been shown to influence cancer stage at diagnosis and, thus, prognosis. The association between these beliefs and survival is understudied, especially among racially/ethnically diverse populations. We investigated the relationship between cancer-specific beliefs and survival in a cohort of African-American and White women with newly diagnosed breast cancer followed for up to 15 years.
  
  
  METHODS
  We examined beliefs about cancer detection, treatment, and curability in a population-based cohort of 145 African-American and 177 White women diagnosed with breast cancer in Connecticut, US, between 1987 and 1989. Cox proportional-hazards models were adjusted for stage at diagnosis, other biomedical variables, socio-demographic and lifestyle factors.
  
  
  RESULTS
  In multivariate models, perceived cancer incurability was associated with a higher risk of death from any cause (hazards ratio (HR)=1.67, 95 confidence interval (CI)=1.11, 2.51). Further control for tumor characteristics, genetic alterations, access to care, and additional psychosocial factors did not alter these findings. Other cancer-specific beliefs examined here were not related to survival.
  
  
  CONCLUSIONS
  Perceived cancer incurability is independently associated with survival among breast cancer patients in fully adjusted models. The identification of the underlying mechanisms of this association has potential for translation into intervention strategies for cancer patients.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520, USA. hosanna.soler@yale.edu
authors.forename: Hosanna
authors.initials: H
authors.lastname: Soler-Vila
authors.forename: Stanislav V
authors.initials: SV
authors.lastname: Kasl
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jones
mesh_terms: D000368:Aged; D001294:Attitude to Health; D044383:Black People / Q000523:psychology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008019:Life Style; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012923:Social Class; D012931:Social Environment; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D044465:White People / Q000523:psychology*; D001741:Black or African American