Even though they may be jeopardizing their future health, nearly one quarter of women who find lumps or other possible breast cancer symptoms don't seek medical attention for 3 months or longer.
Many people think anxiety is the main reason for such delays, but a University of Wisconsin-Madison School of Nursing researcher has found evidence that other factors may play an important role.
"Contrary to popular opinion, we have found that anxiety by itself does not explain women's promptness or procrastination in seeking care for breast cancer
symptoms," said Assistant Professor of Nursing Diane Lauver, PhD, RN, who is also a nurse practitioner at the University of Wisconsin University Health Service's women's health clinic. "We have found that psychosocial factors such as care-seeking habits and a general sense of optimism, as well as other factors, such as having a friend with a breast symptom, combine to influence how women will act." Practical factors consisted of issues such as carrying health insurance and having a standing relationship with a doctor or nurse.
In the study of 135 Caucasian and African-American women, Lauver and her associates used questionnaires and interviews to learn what factors determined when women visited a metropolitan county hospital for breast cancer symptoms. Guided by a theory that explains general human behavior, the researchers measured psychosocial as well as practical factors that could influence the women's care-seeking behavior.
The UW researchers found that 39% of the study participants contacted the health-care system less than 7 days after finding a symptom, but almost 25% waited at least 3 months. Fifteen percent waited 6 months; 4% waited 1 year.
Data show that women who sought care the soonest were the most optimistic about life in general, had a friend with a symptom, or usually sought care promptly when symptoms occurred. Neither family history of breast cancer nor socioeconomic status influenced how soon women sought care.
Furthermore, as she observed in an earlier study, Lauver found that women's level of anxiety was not associated with longer delays in seeking medical care. "In fact, among the women who did not have an established health care practitioner, higher anxiety was associated with less delay," she said.
Findings from Lauver's latest study, reported in a recent issue of Research in Nursing and Health, also showed that race did not figure significantly in determining how soon a woman sought care.
"Overall, Caucasian women are stricken more frequently with breast cancer than African-American women, but African-American women often have a more advanced stage of the disease when they are diagnosed, and a higher death rate," said Lauver. "We thought differences in beliefs and resources might explain these discrepancies, but in this study they did not."
Lauver said that race may not have been a factor in this study because most of the study participants had similar income and education levels, and comparable sources for seeking care.
By better understanding women's feelings, beliefs, and other barriers associated with getting breast cancer screening before symptoms develop, Lauver hopes to identify ways to encourage women to have mammograms as early as possible. She will be examining these issues over the next 4 years with an $880,000 grant from the National Cancer Institute.
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