title: Breast cancer delay in Latinas: the role of cultural beliefs and acculturation.
abstract: Cultural beliefs about breast cancer may act as a barrier to Latina women seeking preventive services or timely follow-up for breast symptoms regardless of access. This study examines the association between factors and breast cancer cultural beliefs and the extent to which cultural beliefs are associated with delays in breast cancer care. Participants who were Latina, ages 30-79, and had been diagnosed with a primary breast cancer were examined (n = 181). Interviews included a 15-item cultural beliefs scale spanning beliefs inconsistent with motivation to seek timely healthcare. Self-reported date of symptom discovery, date of first medical presentation, and date of first treatment were used to construct measures of prolonged patient, clinical, and total delay. Logistic regression with model-based standardization was used to estimate crude and confounder-adjusted prevalence differences for prolonged delay by number of cultural beliefs held. Women held a mean score of three cultural beliefs. The belief most commonly held was, "Faith in God can protect you from breast cancer" (48 %). Holding three or more cultural beliefs was associated with lower acculturation, lower socioeconomic status and less access to care (p < 0.01). After adjusting for age, education, income, acculturation, trust, and insurance, likelihood of prolonged total delay remained 21 percentage points higher in women who held a higher number cultural beliefs (p = 0.02). Cultural beliefs may predispose Latina women to prolong delays in seeking diagnosis and treatment for breast symptoms. Cultural beliefs represent a potential point of intervention to decrease delays among Latina breast cancer patients.
authors: School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
authors: Silvia
authors: S
authors: Tejeda
authors: Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
authors: Rani I
authors: RI
authors: Gallardo
authors: Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Carol Estwing
authors: CE
authors: Ferrans
authors: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street (M/C 923), Chicago, IL, 60612, USA. garthr@uic.edu.
authors: Garth H
authors: GH
authors: Rauscher
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003469:Culture; D057210:Delayed Diagnosis; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D012959:Socioeconomic Factors
keywords: Acculturation; Breast cancer; Cultural beliefs; Hispanic; Patient and clinical delay