Many Factors Prevent Women With Breast Cancer Symptoms From Seeking Medical Help Quickly

Even though they may be jeopardizing their future health, nearlyone quarter of women who find lumps or other possible breast cancersymptoms 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 researcherhas found evidence that other factors may play an important role.

"Contrary to popular opinion, we have found that anxietyby itself does not explain women's promptness or procrastinationin seeking care for breast cancer

symptoms," said Assistant Professor of Nursing Diane Lauver,PhD, RN, who is also a nurse practitioner at the University ofWisconsin University Health Service's women's health clinic. "Wehave found that psychosocial factors such as care-seeking habitsand a general sense of optimism, as well as other factors, suchas having a friend with a breast symptom, combine to influencehow women will act." Practical factors consisted of issuessuch as carrying health insurance and having a standing relationshipwith a doctor or nurse.

In the study of 135 Caucasian and African-American women, Lauverand her associates used questionnaires and interviews to learnwhat factors determined when women visited a metropolitan countyhospital for breast cancer symptoms. Guided by a theory that explainsgeneral human behavior, the researchers measured psychosocialas well as practical factors that could influence the women'scare-seeking behavior.

The UW researchers found that 39% of the study participants contactedthe health-care system less than 7 days after finding a symptom,but almost 25% waited at least 3 months. Fifteen percent waited6 months; 4% waited 1 year.

Data show that women who sought care the soonest were the mostoptimistic about life in general, had a friend with a symptom,or usually sought care promptly when symptoms occurred. Neitherfamily history of breast cancer nor socioeconomic status influencedhow soon women sought care.

Furthermore, as she observed in an earlier study, Lauver foundthat women's level of anxiety was not associated with longer delaysin seeking medical care. "In fact, among the women who didnot have an established health care practitioner, higher anxietywas associated with less delay," she said.

Findings from Lauver's latest study, reported in a recent issueof Research in Nursing and Health, also showed that race did notfigure significantly in determining how soon a woman sought care.

"Overall, Caucasian women are stricken more frequently withbreast cancer than African-American women, but African-Americanwomen often have a more advanced stage of the disease when theyare diagnosed, and a higher death rate," said Lauver. "Wethought differences in beliefs and resources might explain thesediscrepancies, but in this study they did not."

Lauver said that race may not have been a factor in this studybecause most of the study participants had similar income andeducation levels, and comparable sources for seeking care.

By better understanding women's feelings, beliefs, and other barriersassociated with getting breast cancer screening before symptomsdevelop, Lauver hopes to identify ways to encourage women to havemammograms as early as possible. She will be examining these issuesover the next 4 years with an $880,000 grant from the NationalCancer Institute.