From the Journals

Perceived discrimination linked to delay in ovarian cancer diagnosis for black women



Perceived everyday discrimination was associated with an extended duration between symptom onset and cancer diagnosis (prolonged symptom duration) in black women with ovarian cancer, according to results from a case-control analysis.

In contrast, another interpersonal factor, trust in physicians, was not associated with prolonged symptom duration.

“We [examined] the association of everyday discrimination and trust in physicians with a prolonged interval between symptom onset and ovarian cancer diagnosis,” wrote Megan A. Mullins, MPH, of the University of Michigan, Ann Arbor, and colleagues. The findings were published in Cancer.

The analysis included 486 cases of black women with newly diagnosed epithelial ovarian cancer, 302 of whom had prolonged symptom duration. Study cases were obtained from the African American Cancer Epidemiology Study that took place from December 2010 to December 2015. Perceived discrimination was evaluated with the five-question version of the Williams Everyday Discrimination Scale.

In the model, adjustments were made for various demographic characteristics, including marital status, body mass index, and age at diagnosis, among other parameters.

After analysis, the researchers found that every 1-unit rise in the frequency of everyday discrimination was associated with a higher likelihood of prolonged symptom duration (odds ratio, 1.74; 95% confidence interval, 1.22-2.49).

No association was found between trust in physicians and prolonged symptom duration (odds ratio, 0.86; 95% CI, 0.66-1.11).

“These results point to the social context in daily life playing a role in receiving optimal ovarian cancer care,” the researchers wrote.

One key limitation of the study was that the data was obtained in a cross-sectional manner, which could introduce bias because of reverse causality.

“This work is a novel first step in understanding the relationship between interpersonal exposures and racial disparities in ovarian cancer care. More equitable access to ovarian cancer care necessitates that women feel comfortable about advocating for their needs and trust their self-assessment of their symptoms,” they concluded.

The study was funded by the National Cancer Institute, the Metropolitan Detroit Cancer Surveillance System, and the Epidemiology Research Core. The authors reported no conflicts of interest.

SOURCE: Mullins MA et al. Cancer. 2019 Aug 15. doi: 10.1002/cncr.32451.

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