Abstract
Purpose
The objectives of this study are to describe racial/ethnic differences and clinical/treatment correlates of worry about recurrence and examine modifiable factors in the health care experience to reduce worry among breast cancer survivors, partners, and pairs.
Methods
Women with non-metastatic breast cancer identified by the Detroit and Los Angeles SEER registries between 6/05 and 2/07 were surveyed at 9 months and 4 years. Latina and Black women were oversampled. Partners were surveyed at time 2. Worry about recurrence was regressed on sociodemographics, clinical/treatment, and modifiable factors (e.g., emotional support received by providers) among survivors, partners, and pairs.
Results
The final sample included 510 pairs. Partners reported more worry about recurrence than survivors. Compared to Whites, Latinas(os) were more likely to report worry and Blacks were less likely to report worry (all p < 0.05). Partners of survivors who received chemotherapy reported more worry (OR = 2.47 [1.45, 4.22]). Among modifiable factors, survivors and pairs who received more emotional support from providers were less likely to report worry than those survivors and pairs who did not receive such support (OR = 0.56 [0.32, 0.97]) and (OR = 0.45 [0.23,0.85]), respectively.
Conclusions
Early identification of survivors and partners who are reporting considerable worry about recurrence can lead to targeted culturally sensitive interventions to avoid poorer outcomes. Interventions focused on health care providers offering information on risk and emotional support to survivors and partners is warranted.
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Acknowledgments
We acknowledge the outstanding work of our project staff and Denise MacFarlin, Senior Secretary for Nancy Janz; these individuals received compensation for their assistance. We thank the American College of Surgeons Commission on Cancer and the National Cancer Institute Outcomes Branch for their support. We acknowledge with gratitude the breast cancer patients and partners who responded to our surveys.
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Supported by Grants No. R01 CA109696 and R01 CA088370 from the National Cancer Institute (NCI) to the University of Michigan. The work of Lauren Beesley was supported by grant T32 CA-83654 from the National Institutes of Health (NCI). The collection of Los Angeles County cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the NCI’s SEER program under Contract No. N01-PC-35139 awarded to the University of Southern California, Contract No. N01-PC-54,404 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under Agreement No. 1U58DP00807-01 awarded to the Public Health Institute. The collection of metropolitan Detroit cancer incidence data was supported by the NCI SEER program Contract No. N01-PC-35145. The partner study was supported by a grant from the University of Michigan Cancer Center Research Funds.
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The authors declare that they have no conflict of interest.
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Janz, N.K., Li, Y., Beesley, L.J. et al. Worry about recurrence in a multi-ethnic population of breast cancer survivors and their partners. Support Care Cancer 24, 4669–4678 (2016). https://doi.org/10.1007/s00520-016-3314-z
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DOI: https://doi.org/10.1007/s00520-016-3314-z