Nina A. Bickell|Jessica Weidmann|Kezhen Fei|Jeng-Wen Lin|Howard Leventhal
Underuse of Breast Cancer Adjuvant Treatment: Patient Knowledge, Beliefs, and Medical Mistrust
Icahn School of Medicine at Mount Sinai|Rutgers, The State University of New Jersey|Icahn School of Medicine at Mount Sinai|Rutgers, The State University of New Jersey|Icahn School of Medicine at Mount Sinai|Rutgers, The State University of New Jersey|Icahn School of Medicine at Mount Sinai|Rutgers, The State University of New Jersey|Icahn School of Medicine at Mount Sinai|Rutgers, The State University of New Jersey
purpose little known women breast cancer surgery receive proven effective postsurgical adjuvant treatments methods surveyed 258 women recently underwent surgical treatment six new york city hospitals earlystage breast cancer care knowledge beliefs breast cancer treatment per national guidelines women received adjuvant treatment adjuvant treatment data obtained inpatient outpatient charts factor analysis used create scales scored 100 treatment beliefs knowledge medical mistrust physician communication treatment bivariate multivariate analyses assessed differences treated untreated women results compared treated women untreated women less likely know adjuvant therapies increase survival 100point scale 66 v 75 p lt 0001 greater mistrust 64 v 53 p 001 less selfefficacy 92 v 97 p lt 05 physician communication treatment affect patient knowledge treatment benefits r 08 p 21 multivariate analysis found untreated women likely 70 years older adjusted relative risk arr 111 95 ci 100 113 comorbidities arr 110 95 ci 104 112 express mistrust medical delivery system arr 1003 95 ci 100 1007 even though likely believe adjuvant treatments beneficial arr 099 95 ci 098 099 model c 084 p 0001 conclusion patient knowledge beliefs treatment medical mistrust mutable factors associated underuse effective adjuvant therapies physicians may improve cancer care ensuring discussions adjuvant therapy include clear presentation benefits risks treatment addressing patient trust concerns medical system