title: Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer.
abstract: BACKGROUND
  Worry about recurrence (worry) is a persistent concern of breast cancer survivors. Little is known about whether race/ethnicity or healthcare experiences are associated with worry.
  
  
  METHODS
  Women with nonmetastatic breast cancer diagnosed from June 2005 to February 2007 and reported to Detroit or Los Angeles Surveillance, Epidemiology, and End Results registries were surveyed (mean 9 months postdiagnosis); 2290 responded (73%). Latinas and African Americans were oversampled. A worry scale was constructed as the mean score of 3 items (on 5-point Likert, higher = more worry): worry about cancer returning to the same breast, occurring in the other breast, or spreading to other parts of the body. Race/ethnicity categories were white, African American, and Latina (categorized into low vs high acculturation). The worry scale was regressed on sociodemographics, clinical/treatment, and healthcare experience factors (eg, care coordination collapsed into low, medium, high).
  
  
  RESULTS
  Low acculturated Latinas reported more worry and African Americans less worry than whites (P < .001). Other factors independently associated with more worry were younger age, being employed, more pain and fatigue, and radiation (Ps < .05). With all factors in the model, less worry was associated (all Ps < .05) with greater ease of understanding information (2.89, 2.99, 2.81 for low, medium, high), better symptom management (3.19, 2.89, 2.87 for low, medium, high), and more coordinated care (3.36, 2.94, 2.82 for low, medium, high). Race/ethnicity remained significant controlling for all factors (P < .001).
  
  
  CONCLUSIONS
  Less acculturated Latina breast cancer patients are vulnerable to high levels of worry. Interventions that improve information exchange, symptom management, and coordinating care hold promise in reducing worry.
authors: Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-20296, USA. nkjanz@umich.edu
authors: Nancy K
authors: NK
authors: Janz
authors: Sarah T
authors: ST
authors: Hawley
authors: Mahasin S
authors: MS
authors: Mujahid
authors: Jennifer J
authors: JJ
authors: Griggs
authors: Amy
authors: A
authors: Alderman
authors: Ann S
authors: AS
authors: Hamilton
authors: John J
authors: JJ
authors: Graff
authors: Reshma
authors: R
authors: Jagsi
authors: Steven J
authors: SJ
authors: Katz
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000523:psychology*; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D044465:White People