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Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study.

Publication ,  Journal Article
Mullins, MA; Peres, LC; Alberg, AJ; Bandera, EV; Barnholtz-Sloan, JS; Bondy, ML; Funkhouser, E; Moorman, PG; Peters, ES; Terry, PD; Lawson, AB ...
Published in: Cancer
December 15, 2019

BACKGROUND: Discrimination and trust are known barriers to accessing health care. Despite well-documented racial disparities in the ovarian cancer care continuum, the role of these barriers has not been examined. This study evaluated the association of everyday discrimination and trust in physicians with a prolonged interval between symptom onset and ovarian cancer diagnosis (hereafter referred to as prolonged symptom duration). METHODS: Subjects included cases enrolled in the African American Cancer Epidemiology Study, a multisite case-control study of epithelial ovarian cancer among black women. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations of everyday discrimination and trust in physicians with a prolonged symptom duration (1 or more symptoms lasting longer than the median symptom-specific duration), and it controlled for access-to-care covariates and potential confounders. RESULTS: Among the 486 cases in this analysis, 302 women had prolonged symptom duration. In the fully adjusted model, a 1-unit increase in the frequency of everyday discrimination increased the odds of prolonged symptom duration 74% (OR, 1.74; 95% CI, 1.22-2.49), but trust in physicians was not associated with prolonged symptom duration (OR, 0.86; 95% CI, 0.66-1.11). CONCLUSIONS: Perceived everyday discrimination was associated with prolonged symptom duration, whereas more commonly evaluated determinants of access to care and trust in physicians were not. These results suggest that more research on the effects of interpersonal barriers affecting ovarian cancer care is warranted.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

December 15, 2019

Volume

125

Issue

24

Start / End Page

4442 / 4451

Location

United States

Related Subject Headings

  • United States
  • Trust
  • Racism
  • Public Health Surveillance
  • Physician-Patient Relations
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasm Staging
  • Middle Aged
 

Citation

APA
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Mullins, M. A., Peres, L. C., Alberg, A. J., Bandera, E. V., Barnholtz-Sloan, J. S., Bondy, M. L., … Cote, M. L. (2019). Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study. Cancer, 125(24), 4442–4451. https://doi.org/10.1002/cncr.32451
Mullins, Megan A., Lauren C. Peres, Anthony J. Alberg, Elisa V. Bandera, Jill S. Barnholtz-Sloan, Melissa L. Bondy, Ellen Funkhouser, et al. “Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study.Cancer 125, no. 24 (December 15, 2019): 4442–51. https://doi.org/10.1002/cncr.32451.
Mullins MA, Peres LC, Alberg AJ, Bandera EV, Barnholtz-Sloan JS, Bondy ML, et al. Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study. Cancer. 2019 Dec 15;125(24):4442–51.
Mullins, Megan A., et al. “Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study.Cancer, vol. 125, no. 24, Dec. 2019, pp. 4442–51. Pubmed, doi:10.1002/cncr.32451.
Mullins MA, Peres LC, Alberg AJ, Bandera EV, Barnholtz-Sloan JS, Bondy ML, Funkhouser E, Moorman PG, Peters ES, Terry PD, Schwartz AG, Lawson AB, Schildkraut JM, Cote ML. Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study. Cancer. 2019 Dec 15;125(24):4442–4451.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

December 15, 2019

Volume

125

Issue

24

Start / End Page

4442 / 4451

Location

United States

Related Subject Headings

  • United States
  • Trust
  • Racism
  • Public Health Surveillance
  • Physician-Patient Relations
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasm Staging
  • Middle Aged