218531 Seeking cancer care: Health equity and access to state-of-the-art care

Monday, November 8, 2010

Elizabeth Gage, PhD , Department of Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
Levi Ross , Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
Elisa Rodriguez, PhD, MS , Department of Health Behavior, SUNY Buffalo School of Public Health and Health Professions, Buffalo, NY
Frances Saad-Harfouche, MSW , Department of Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
Deborah O. Erwin, PhD , Department of Cancer Control Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
Minority patients may be less likely to receive optimal treatment such as surgery and chemotherapy for many cancers (Shavers, Brown 2002). Previous research has demonstrated that institutions that offer clinical treatment studies and perform a high volume of specialized care and surgeries for cancer have better patient outcomes and fewer complications than many community hospitals (Hilner, Smith, Christopher 2000). However, research has not yet examined the complicated processes though which patients select the setting in which they receive their cancer care, and how this varies by race. A mixed methods study of a random sample of 50 African American and 75 White patients at a comprehensive cancer center was designed to examine experiences with medical care, perceived racial discrimination, and use of social capital for obtaining care. Ninety-seven percent of all patients had a PCP, and the majority sought care at the cancer center through direct physician referral rather than self-referral. This suggests the importance of collaboration and referral patterns within the local and regional medical community. African American patients experienced significantly more perceived discrimination (74% v. 4%; p = 0.000) in all areas of their life including medical care, had lower family incomes, and were less likely to report being offered a clinical trial (22% v. 37%) than White patients. Qualitative findings demonstrated differences in the use of social capital for seeking cancer care. These results contribute to our understanding of the internal and external processes that influence the ability of all patients to obtain optimal cancer treatment.

Learning Areas:
Diversity and culture
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1. Differentiate qualitative and quantitative variations in the process of seeking cancer care for White and African American patients. 2. Identify influential variables that can be modified to enhance optimal cancer treatment for vulnerable and minority patients. 3. Evaluate potential impact of findings for patient participation in clinical studies.

Keywords: Cancer, Care Seeking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualied to be an presenting/abstract Author because I have advanced degrees in health education/promotion and I have been conducting health disparities research for more than ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.