The researchers speculated that factors such as cultural beliefs, access to health care, other illnesses and patient choice may all play a role.
To try to get more of these women to accept treatment, Rizzo's group has started a community outreach program that uses a nurse practitioner and a social worker to follow breast cancer patients and their care.
Educating women is also important, Rizzo said. "Educate more women and dispel some fears that they can have about cancer and cancer treatment, and encourage them to have yearly mammograms to catch cancers at an earlier stage, when the cancer is more curable," she said.
Breast cancer expert Dr. Gretchen G. Kimmick, an associate professor of oncology at Duke University Medical Center, thinks these results are concerning.
"This finding, that a large proportion of these women were not getting chemotherapy or radiation, is worrisome," Kimmick said.
"I think it's a social and cultural thing," Kimmick said. "We have to educate and be sensitive to cultural issues, too. Some of the women we take care of think God is going to take care of them, so they don't pursue their treatment," she said. "Sometimes that's how they deal with crisis."
Kimmick thinks poverty has an influence as well. "Lower-income patients don't have the job security that some other people have. If they are absent form their job for days in a row, they're going to lose their job," she said. "They are also embarrassed they can't pay."
More needs to be done to remove these disparities, Kimmick said. "Disparities are not just fixed by telling people what they need to do -- you have to help them do it," she said.
Barbara A. Brenner, executive director of Br
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