Cancer Control Research5R21CA109201-02
Gomez, Scarlett L.
CULTURE AND ETHNIC VARIATIONS IN BREAST CANCER TREATMENT
Asian ethnic subgroups, particularly Chinese and Vietnamese, have higher rates of mastectomy for early stage breast cancer, raising concerns about possible over-treatment. To address the factors affecting treatment decision-making processes and consequent quality of life in these groups, the roles of socio-cultural, demographic, and clinical factors must first be determined for each ethnic group. For this 2-year developmental/pilot study, we propose to apply qualitative research methods to inform the development of linguistically and culturally appropriate questionnaires related to treatment decision-making and quality of life, and to pilot test the instruments in a population-based sample of non-Hispanic White, Chinese, and Vietnamese women recently diagnosed with breast cancer. Study results will form the basis for planning a larger, population-based epidemiologic study. Study aims are to: 1) identify the socio-cultural, co-decision making, provider communication, and other factors in treatment decision-making processes and quality of life in each ethnic group through the following procedures: a) focus group interviews with patients, b) qualitative interviews with patients, and c) qualitative interviews with patients' co-decision makers; 2) determine provider practices and perceptions regarding treatment recommendations and decision-making processes via provider surveys; and 3) develop and test ethnic-specific epidemiologic questionnaires through cognitive interviews and an epidemiologic pilot study in a population-based patient sample. An overall enrollment of 43 White, 56 Chinese, and 43 Vietnamese patients; 20 family or friends identified as the co-decision maker; and 60 providers are expected. As little is known about factors contributing to disparities in standards of care for early-stage breast cancer among ethnic groups, and about the contributions of socio-cultural factors on treatment decisions, and impacts on quality of life, this developmental/pilot study should contribute the information necessary to plan a larger study to understand these issues for specific ethnic groups.