Perceptions of cancer care may not match reality
“It was really what it took to get the care,” said Bickell. “Ultimately they got it, but it’s what they had to go through to get the care.”
For black women, however, there was something else at play.
The researchers found that only 39 percent of black women said they got “excellent” care compared to 60 percent of whites and 62 percent of Hispanics.
Breast cancer is by far the commonest cancer in women in the UK accounting for 31% of all cases in women. The next most common cancer in women is lung cancer, with 17,960 cases (12% of total) in 2008. So nearly a third of all new cancers in women are breast cancers. It has been estimated that the lifetime risk of developing breast cancer in 2008 is 1 in 1,014 for men and 1 in 8 for women in the UK.
Breast cancer risk is strongly related to age, with 81% of cases occurring in women aged 50 years and over. Nearly half (48%) of cases of breast cancer are diagnosed in the 50-69 age group: these women and those aged 70 are targeted in the national screening programme. In 2006, the NHS Breast Screening Programme announced its intention to extend the age range of women eligible for breast screening to ages 47 to 73. The extension which is being carried out as a randomised trial is due to be completed by 2016.
Overall, black women were also less likely to trust their physician and more likely to perceive racism in the process of getting care. But, the researchers found there were no differences in the actual quality of care black women received compared to whites and Hispanics.
“Thus, something is being communicated to black women that results in their lower levels of trust and higher perceived racism,” the researchers write in the Journal of Clinical Oncology. “These sentiments vary among black women, which suggests that there are ways to redress this critical issue.”
“This is a very specific and quite significant finding that black women perceived racism in the way they were getting care. That’s something that’s got to change,” said Jessie Gruman, president of the Center for Advancing Health in Washington - an organization that works on patient engagement.
Gruman, who was not involved with the new study, told Reuters Health that care can conform to guidelines and standards, but it won’t be good enough if it’s provided in an unpleasing way.
Bickell said that it comes down to hospitals, doctors’ offices and other players in the healthcare delivery system to change the culture on the best way to take care of patients.
That means making it easier for patients to make appointments, get referrals and test results, letting them know what the next steps are and telling the patient what they need to know to make it happen, she said.
“I think we can do it, and I think we have to do it,” said Bickell.