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. 2011 May 1;117(9):1827-36.
doi: 10.1002/cncr.25740. Epub 2011 Mar 28.

Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer

Nancy K Janz  1 , Sarah T Hawley, Mahasin S Mujahid, Jennifer J Griggs, Amy Alderman, Ann S Hamilton, John J Graff, Reshma Jagsi, Steven J Katz
Affiliations

Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer

Nancy K Janz et al. Cancer. .

Abstract

Background: Worry about recurrence (worry) is a persistent concern of breast cancer survivors. Little is known about whether race/ethnicity or healthcare experiences are associated with worry.

Methods: Women with nonmetastatic breast cancer diagnosed from June 2005 to February 2007 and reported to Detroit or Los Angeles Surveillance, Epidemiology, and End Results registries were surveyed (mean 9 months postdiagnosis); 2290 responded (73%). Latinas and African Americans were oversampled. A worry scale was constructed as the mean score of 3 items (on 5-point Likert, higher = more worry): worry about cancer returning to the same breast, occurring in the other breast, or spreading to other parts of the body. Race/ethnicity categories were white, African American, and Latina (categorized into low vs high acculturation). The worry scale was regressed on sociodemographics, clinical/treatment, and healthcare experience factors (eg, care coordination collapsed into low, medium, high).

Results: Low acculturated Latinas reported more worry and African Americans less worry than whites (P < .001). Other factors independently associated with more worry were younger age, being employed, more pain and fatigue, and radiation (Ps < .05). With all factors in the model, less worry was associated (all Ps < .05) with greater ease of understanding information (2.89, 2.99, 2.81 for low, medium, high), better symptom management (3.19, 2.89, 2.87 for low, medium, high), and more coordinated care (3.36, 2.94, 2.82 for low, medium, high). Race/ethnicity remained significant controlling for all factors (P < .001).

Conclusions: Less acculturated Latina breast cancer patients are vulnerable to high levels of worry. Interventions that improve information exchange, symptom management, and coordinating care hold promise in reducing worry.

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Figures

Figure 1
Figure 1. Modified stress/appraisal theoretical framework
Figure 2
Figure 2. Percent of women reporting levels of worry by race/ethnicity
Figure 3
Figure 3. Unadjusted mean wony scores for three health care experience factors
See this image and copyright information in PMC

References

    1. Lee-Jones C, Humphris G, Dixon R, Bebbington Hatcher M. Fear of cancer recurrence -- A literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psycho-Oncology. 1997;6:95–105. - PubMed
    1. van den Beuken-van Everdingen MH, Peters ML, de Rijke JM, Schouten HC, van Kleef M, Patijn J. Concerns of former breast cancer patients about disease recurrence: A validation and prevalence study. Psycho-Oncology. 2008;17:1137–1145. - PubMed
    1. Vickberg SM. The concerns about recurrence scale (CARS): A systematic measure of women's fears about the possibility of breast cancer recurrence. Ann Behav Med. 2003;25:16–24. - PubMed
    1. Baker F, Denniston M, Smith T, West MM. Adult cancer survivors: How are they faring? Cancer. 2005;104:2565–2576. - PubMed
    1. Kornblith AB, Powell M, Regan MM, Bennett S, Krasner C, Moy B, et al. Long-term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer. Psycho-Oncology. 2007;16:895–903. - PubMed

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