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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Behavioral and Social Science

Abstract PR07: Racial-ethnic disparities in patient-provider communication and overall perceptions of follow-up care quality among adult cancer survivors.

Nynikka R.A. Palmer, Neeraj K. Arora, Erin Kent, Laura Forsythe, Julia H. Rowland, Noreen Aziz and Kathryn E. Weaver
Nynikka R.A. Palmer
1Wake Forest School of Medicine, Winston-Salem, NC,
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Neeraj K. Arora
2National Cancer Institute, Bethesda, MD.
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Erin Kent
2National Cancer Institute, Bethesda, MD.
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Laura Forsythe
2National Cancer Institute, Bethesda, MD.
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Julia H. Rowland
2National Cancer Institute, Bethesda, MD.
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Noreen Aziz
2National Cancer Institute, Bethesda, MD.
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Kathryn E. Weaver
1Wake Forest School of Medicine, Winston-Salem, NC,
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DOI: 10.1158/1055-9965.DISP12-PR07 Published October 2012
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Abstract

Purpose: Poor patient-provider communication (PPC) may contribute to racial-ethnic disparities in healthcare, and is critical to quality cancer survivorship care. Racial-ethnic differences in PPC have been noted among cancer survivors; however, previous studies have focused primarily on comparing White and African American patients and survivors recently diagnosed or treated for cancer. This study examined racial-ethnic differences in PPC and its association with perceived follow-up care quality among a diverse sample of long-term cancer survivors.

Methods: Survivors of breast, prostate, colorectal, ovarian and endometrial cancers were recruited from Surveillance Epidemiology and End Results cancer registries in California to complete a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic White (White) cancer survivors were selected for this analysis if they had seen a doctor for cancer-related follow-up care in the past two years (n=1215). We conducted linear regression analyses to identify racial-ethnic differences in PPC (general follow-up care communication and explanation of medical tests). We used logistic regression models to examine the association between race-ethnicity and dichotomized perceived follow-up care quality outcomes: overall rating (very good/excellent vs. poor/fair/good) and receipt of desired help with symptoms/side effects (usually/always vs. never/sometimes). Finally, we added PPC to the adjusted logistic regression models to assess the effect of PPC on racial-ethnic differences in perceived follow-up care quality, adjusting for covariates (age, gender, education, insurance, comorbidities, cancer treatment modalities, cancer site, stage at diagnosis, number of provider visits for follow-up care, time since most recent follow-up care visit, duration of relationship with follow-up care provider, and whether it was the same provider seen for cancer treatment).

Results: Of the 1215 survivors, 24% were African American, 22% were Asian, 13% were Hispanic, and 39% were White. Compared to White survivors, all minority survivors reported poorer explanation of medical tests (F=4.69, p=0.003), and Asian and Hispanic survivors reported poorer follow-up care communication (F=11.42, p<0.001). Asian survivors were also less likely to report receipt of desired help with symptoms/side effects (OR=0.46, 95%CI: 0.27-0.79), and both African American and Asian survivors were less likely to report high overall ratings of follow-up care quality (OR= 0.55, 95%CI: 0.38-0.79 and OR=0.43, 95%CI: 0.30-0.62, respectively) compared to White survivors. In fully adjusted models, including PPC, Asian survivors remained less likely to rate overall follow-up care quality as good/excellent (OR: 0.51, 95%CI: 0.28-0.93) compared to White survivors. No other significant racial-ethnic differences persisted.

Conclusions: Both Asian and Hispanic survivors reported poorer PPC. For some survivors, PPC may help to explain disparities in perceived follow-up care quality; however, Asian survivors reported poorer overall ratings of follow-up care, despite controlling for covariates and PPC. Addressing PPC is important as poor communication may also affect survivors' ability to actively participate in follow-up care.

This abstract is also presented as Poster A12.

Citation Format: Nynikka R.A. Palmer, Neeraj K. Arora, Erin Kent, Laura Forsythe, Julia H. Rowland, Noreen Aziz, Kathryn E. Weaver. Racial-ethnic disparities in patient-provider communication and overall perceptions of follow-up care quality among adult cancer survivors. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr PR07.

  • ©2012 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 21 (10 Supplement)
October 2012
Volume 21, Issue 10 Supplement
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Abstract PR07: Racial-ethnic disparities in patient-provider communication and overall perceptions of follow-up care quality among adult cancer survivors.
Nynikka R.A. Palmer, Neeraj K. Arora, Erin Kent, Laura Forsythe, Julia H. Rowland, Noreen Aziz and Kathryn E. Weaver
Cancer Epidemiol Biomarkers Prev October 1 2012 (21) (10 Supplement) PR07; DOI: 10.1158/1055-9965.DISP12-PR07

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Abstract PR07: Racial-ethnic disparities in patient-provider communication and overall perceptions of follow-up care quality among adult cancer survivors.
Nynikka R.A. Palmer, Neeraj K. Arora, Erin Kent, Laura Forsythe, Julia H. Rowland, Noreen Aziz and Kathryn E. Weaver
Cancer Epidemiol Biomarkers Prev October 1 2012 (21) (10 Supplement) PR07; DOI: 10.1158/1055-9965.DISP12-PR07
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