When researchers at Moffitt Cancer Center and colleagues conducted a
random telephone survey among blacks, whites and Hispanics in New York,
Baltimore and San Juan, Puerto Rico, they found that Hispanics are
nearly twice as likely to report that fear of being used as a "guinea
pig" and lack of trust in medical professionals contribute in being
unwilling to participate in cancer
screenings. The researchers concluded that health care providers need
to do a better job of instilling trust and dispelling certain fears,
particularly among Hispanics, to improve cancer screening rates for
lower-income minorities.
The study appeared in a supplement in the November issue of the Journal of Health Care for the Poor and Underserved.
"The provider-patient relationship is an important factor in patients
adhering to cancer screening recommendations," said study senior author
B. Lee Green, Ph.D., senior member of the Health Outcomes and Behavior
Program at Moffitt. "This study found differences between
sociodemographic groups in levels of fear and mistrust with regard to
the provider-patient relationships and communications that may
contribute to unwillingness to participate in cancer screenings."
According to the authors, the reasons for disparities in cancer
screening behavior have been less apparent for minorities than for
others, and few studies have aimed at understanding why.
The researchers found that when compared to whites, Hispanics were
nearly twice as likely to report a fear of being a guinea pig, and a
lack of trust in health care professionals would contribute to
unwillingness to participate in cancer screenings. Noncollege-educated
individuals with less than a high school education or diploma were found
to be twice as likely as college graduates to fear embarrassment during
screening.
Screening offers opportunities for early detection, diagnosis and
treatment. Given the disparities in cancer screening utilization and the
adverse health implications of such disparities, it is critical to
understand the factors contributing to the problem, said the authors.
"The purpose of this analysis was to assess sociodemographic factors
associated with fears and mistrust as related to the patient-provider
relationship that may contribute to unwillingness to participate in
cancer screenings," they wrote. "Our results indicate that racial,
ethnic and educational discrepancies exist regarding fears and mistrust.
Results also indicate areas where health professionals can improve
interactions with patients, particularly among Hispanics and those with
lower educational attainment."
The researchers added that communication can be especially difficult
where there are language barriers, yet improving patient-provider
communication "holds tremendous promise because it offers one of the
more readily changeable contributors to cancer screening adherence."
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