title: Factors associated with delays in screening of self-detected breast changes in African-American women.
abstract: Breast cancer mortality is higher among African-American women than among White women. African-American women are 25% more likely to present with late stage breast cancer and 20% more likely to die from breast cancer than White women. Treatment delay of 3 months is a significant factor in breast cancer mortality The purpose of this integrative review is to explore factors that impact delays in screening The most common patient-controlled delays were lack of education and knowledge about the perceived seriousness of breast symptoms, the associated risk factors, limited knowledge regarding the potential benefits of early detection in improving breast cancer survival, and expressed fatalistic perspectives about breast cancer. Other variables related to delays included factors such as advancing age, low socioeconomic status, fear of diagnosis, consequences of cancer treatments, shame and embarrassment, misconceptions about the etiology of breast cancer, family priorites, denial, and spirituality including faith-influenced delays.
authors.affiliation: Inpatient Oncology and Transplant Services, Emory University Hospital, Crawford Long Hospital, Atlanta, GA 30308, USA. mary.gullatte@emory.healthcare.org
authors.forename: Mary Magee
authors.initials: MM
authors.lastname: Gullatte
authors.forename: Janice M
authors.initials: JM
authors.lastname: Phillips
authors.forename: Lynette M
authors.initials: LM
authors.lastname: Gibson
mesh_terms: D001741:Black or African American / Q000193:education / Q000208:ethnology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D016504:Breast Self-Examination / Q000523:psychology; D003717:Denial, Psychological; D004522:Educational Status; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D012107:Research Design; D012307:Risk Factors; D012752:Shame; D012959:Socioeconomic Factors; D029181:Spirituality; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014930:Women / Q000193:education / Q000523:psychology*