Breast Cancer Research and Treatment

, Volume 40, Issue 1, pp 25–35 | Cite as

Ethnic differences in risk perception among women at increased risk for breast cancer

  • Chanita Hughes
  • Caryn Lerman
  • Edward Lustbader
Guest editor's introduction

Summary

There has been increasing interest in the role of cultural and ethnic factors in breast cancer risk perceptions and screening practices. This study examined ethnic differences in breast cancer risk perception in 112 African American and 224 white women ages 35 and older who had at least one first-degree relative diagnosed with breast cancer. These samples were matched for education and age. Data on breast cancer risk factors, risk perceptions, breast cancer worries, and breast cancer screening practices were collected through structured telephone interviews. The results show that African American women were significantly less likely than white women to report heightened perceptions of personal risk after their relative was diagnosed with breast cancer (61% vs 82%; p<.001). Despite this, African American women had significantly greater concerns about their personal risk of breast cancer and worries about their affected relative. African American women also scored significantly higher than white women on a measure of avoidance of breast cancer-related thoughts and feelings. These psychological variables were associated independently with breast cancer risk perception in multivariate models, taking precedence over demographic and risk factor predictors. Observed ethnic differences in breast cancer risk perceptions and psychological distress may be attributable to the influence of cultural factors particular to people of African descent, such as the importance of interpersonal relationships, spirituality, and time orientation. An Africentric perspective is used to interpret these findings and to provide suggestions for delivering effective breast cancer risk counseling to African American women.

Key words

African American women Africentric perspective avoidance cultural factors ethnicity risk perception screening practices sociodemographics 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    American Cancer Society: Cancer and the socioeconomically disadvantaged. American Cancer Society Professional Education Publication, 1990.Google Scholar
  2. 2.
    Bang KM, Perlin E, Sampson CC: Increased cancer risks in blacks: A look at the factors. J Natl Med Assoc 79:383–388, 1987.PubMedGoogle Scholar
  3. 3.
    Gamble VN: A legacy of distrust: African Americans and medical research. Am J Prev Med 9:35–38, 1993.PubMedGoogle Scholar
  4. 4.
    Evaxx, Inc.: Black Americans' attitudes toward cancer and cancer tests: Highlights of a study. CA-A Cancer Journal for Clinicians 31:212–218, 1981.PubMedGoogle Scholar
  5. 5.
    Loehrer PJ, Greger HA, Weinberger M, Musick B, Miller M, Nichols C, Bryan J, Higgs D, Brock D: Knowledge and beliefs about cancer in a socioeconomically disadvantaged population. Cancer 68:1665–1671, 1991.PubMedGoogle Scholar
  6. 6.
    Glanz K, Resch N, Lerman C, Rimer BK: Black-White differences in factors influencing mammography use among employed women HMO members. Ethnicity & Disease (in press).Google Scholar
  7. 7.
    Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81:1879–1886, 1989.PubMedGoogle Scholar
  8. 8.
    Lerman C, Daly M, Sands C, Balshem A, Lustbader E, Heggan T, Goldstein L, James J, Engstrom P: Mammography adherence and psychological distress among women at risk for breast cancer. J Natl Cancer Inst 85:1074–1080, 1993.PubMedGoogle Scholar
  9. 9.
    Lerman C, Rimer BK, Daly M, Lustbader E, Sands C, Balshem A, Masny A, Engstrom P: Recruiting high risk women into a breast cancer health promotion trial. Cancer Epidemiol, Biomarkers, & Prev 3:271–276, 1994.Google Scholar
  10. 10.
    Horowitz M, Wilner N, Alvarez W: Impact of Event Scale: A measure of subjective stress. Psychosom Med 41:209–218, 1979.PubMedGoogle Scholar
  11. 11.
    Kash KM, Holland JC, Halper MS, Miller DG: Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Natl Cancer Inst 84:24–30, 1992.PubMedGoogle Scholar
  12. 12.
    Jepson C, Kessler LG, Portnoy B, Gibbs B: Blackwhite differences in cancer prevention knowledge and behavior. Am J Pub Health 81:501–504, 1991.PubMedGoogle Scholar
  13. 13.
    Jackson AP, Sears SS: Implications of an Africentric worldview in reducing stress for African American women. J Counseling and Dev 71:184–190, 1992.Google Scholar
  14. 14.
    Nobles W: African philosophy: Foundations for black psychology.In: Jones R (ed) Black Psychology (2nd ed). Harper & Row, New York, 1980, pp 23–36.Google Scholar
  15. 15.
    Littlejohn-Blake SM, Darling CA: Understanding the strengths of African American families. J Black Studies 23:460–471, 1993.Google Scholar
  16. 16.
    Dilworth-Anderson P: Extended kin networks in black families. Generations 16:29–32, 1992.Google Scholar
  17. 17.
    Ulbrich PM, Warheit GJ, Zimmerman RS: Race, socioeconomic status, and psychological distress: An examination of differential vulnerability. J Health and Soc Behavior 30:131–146, 1989.Google Scholar
  18. 18.
    Symth KA, Williams PD: Patterns of coping in black working women. Behavioral Medicine 17(1): 40–46, 1991.PubMedGoogle Scholar
  19. 19.
    Neighbors HW, Jackson J, Bowman P, Gurin G: Stress, coping, and black mental health: Preliminary findings from a national study. Prevention in Human Services 2:125, 1983.Google Scholar
  20. 20.
    Stefanek ME: Counseling women at high risk for breast cancer. Oncol 4:27–38, 1990.Google Scholar
  21. 21.
    Kelly PT: Understanding Breast Cancer Risk. Temple University Press, Philadelphia, 1991.Google Scholar
  22. 22.
    Kang SH, Bloom JR: Social support and cancer screening among older black Americans. J Natl Cancer Inst 85:737–742, 1993.PubMedGoogle Scholar
  23. 23.
    Chandler CK, Holden JM, Kolander CA: Counseling for spiritual wellness: Theory and practice. J Counseling and Development 71:168–75, 1992.Google Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Chanita Hughes
    • 1
  • Caryn Lerman
    • 1
  • Edward Lustbader
    • 2
  1. 1.Lombardi Cancer CenterGeorgetown University Medical CenterWashington DCUSA
  2. 2.Fox Chase Cancer CenterPhiladelphiaUSA

Personalised recommendations