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Delays in Breast Cancer Care by Race and Sexual Orientation: Results From a National Survey with Diverse Women in the United States

Citation

Poteat, Tonia; Adams, Mary Anne; Malone, Jowanna; Geffen, Sophia R.; Greene, Naomi; Nodzenski, Michael; Lockhart, Alexandre G.; Su, I-Hsuan; & Dean, Lorraine T. (2021). Delays in Breast Cancer Care by Race and Sexual Orientation: Results From a National Survey with Diverse Women in the United States. Cancer, 127(19), 3514-3522.

Abstract

BACKGROUND: Despite known differences in breast cancer by both race and sexual orientation, data on the intersectional experiences of Black sexual minority women (BSMW) along the care continuum are scant. This study sought to understand delays in breast cancer care by examining the intersection of race and sexual orientation.
METHODS: This online, cross-sectional survey enrolled racially and sexually diverse women aged ≥ 35 years who had been diagnosed with breast cancer within the prior 10 years or had an abnormal screening in the prior 24 months. The authors calculated summary statistics by race/sexual orientation categories, and they conducted univariate and multivariable modeling by using multiple imputation for missing data.
RESULTS: BSMW (n = 101) had the highest prevalence of care delays with 5.17-fold increased odds of a care delay in comparison with White heterosexual women (n = 298) in multivariable models. BSMW reported higher intersectional stigma and lower social support than all other groups. In models adjusted for race, sexual orientation, and income, intersectional stigma was associated with a 2.43-fold increase in care delays, and social support was associated with a 32% decrease in the odds of a care delay.
CONCLUSIONS: Intersectional stigma may be an important driver of breast cancer inequities for BSMW. Reducing stigma and ensuring access to appropriate social support that addresses known barriers can be an important approach to reducing inequities in the breast cancer care continuum.

URL

http://dx.doi.org/10.1002/cncr.33629

Reference Type

Journal Article

Year Published

2021

Journal Title

Cancer

Author(s)

Poteat, Tonia
Adams, Mary Anne
Malone, Jowanna
Geffen, Sophia R.
Greene, Naomi
Nodzenski, Michael
Lockhart, Alexandre G.
Su, I-Hsuan
Dean, Lorraine T.

Article Type

Regular

Continent/Country

United States of America

State

Nonspecific

Race/Ethnicity

Black

Sex/Gender

Ciswomen

ORCiD

Poteat - 0000-0001-6541-3787