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Minorities Distrust Medical System More

Study finds levels of skepticism correlate with lower cancer screening rates

FRIDAY, Feb. 6 (HealthDay News) -- Minority women, especially black women, have more distrust of the medical system, which leads to delays in screening for breast cancer, new research shows.

Almost half of all women agreed that they had "sometimes been deceived or misled by health-care organizations." Eighteen percent strongly agreed with the statement.

On another gauge of mistrust, 39 percent of black women agreed that "health-care organizations don't always keep your information totally private," versus 15 percent of Latinas and 9 percent of Arab-American women.

More mistrust corresponded with lower screening rates.

"While insurance obviously plays a large role in screening [94 percent of blacks had insurance, 45 percent of Latinas and 43 percent of Arab-American women], we can't ignore that medical mistrust plays a large role. We need to think about tailoring our interventions," said study author Karen Patricia Williams, an assistant professor at Michigan State University's College of Human Medicine in Lansing.

The study was presented Thursday at the American Association for Cancer Research's Conference on the Science of Cancer Health Disparities, in Carefree, Ariz.

It was one of four studies that were highlighted in a Thursday news conference, at which Williams and others spoke.

A second study found troubling misunderstandings among Hispanics about the human papillomavirus (HPV), which is sexually transmitted and can cause cervical cancer.

In general, many of the men and women interviewed (who were HPV-negative), did not know much about HPV; many confused this virus with HIV.

"There was a lot of fatalism among women when told about the relationship between HPV and cervical cancer," added study author Maria E. Fernandez, an assistant professor of health promotion and behavioral sciences at the University of Texas Health Science Center at Houston, School of Public Health. "They thought of it as a death sentence."

Men were more concerned about diagnosis and treatment but also felt that a woman disclosing her HPV status was an admission of infidelity. But, as the interviews continued, they realized the travels of the virus could be ambiguous and that the man, in fact, could have infected the woman.

A third study, from the Jane Addams College of Social Work at the University of Illinois-Chicago, found that reasons for screening or not screening varied, depending on the specific cancer involved. Forty percent of participants did not have health insurance, though almost two-thirds had a regular doctor.

A fourth and final study delved into why progress in recruiting minorities and women into clinical trials has been slow from the clinicians' perspective.

Lack of institutional support and lack of incentives in individual oncology clinics (both public and private) emerged as key obstacles to effective recruitment.

"None of the places we studied had very effective recruitment programs," said study author Daniel Dohan, an associate professor of health policy and social medicine at the University of California San Francisco. Doctors also tended to put a premium on immediate care, rather than matching someone with the appropriate trial.

More information

The U.S. Centers for Disease Control and Prevention has more on cancer disparities among minorities.

SOURCES: Feb. 5, 2009, teleconference with Karen Patricia Williams, Ph.D., assistant professor, College of Human Medicine, Michigan State University, Lansing; Maria E. Fernandez, Ph.D., assistant professor, health promotion and behavioral sciences, University of Texas Health Science Center at Houston, School of Public Health; and Daniel Dohan, Ph.D., associate professor, health policy and social medicine, University of California, San Francisco

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