February 5, 2009 / 8:14 PM / in 9 years

Mistrust makes some women delay breast exam

NEW YORK (Reuters Health) - A lack of trust in the health care system leads many women from minority groups to delay breast cancer screening, according to results of a study reported Thursday at the American Association for Cancer Research conference on the Science of Health Care Disparities in Carefree, Arizona.

“Our medical systems, in general, have some work to do to build better-trusted relationships with racial and ethnic women,” Dr. Karen Patricia Williams from Michigan State University in East Lansing told the conference.

Williams and colleagues analyzed medical mistrust and breast cancer screening behaviors among 116 African American, 113 Latina, and 112 Arab American women who were eligible for screening; their average age was 46 years.

Ninety-four percent of African American women had health insurance, as did 45 percent and 43 percent, respectively, of Latina and Arab American women.

The researchers found that women who had not received appropriately timed clinical breast exams had higher levels of medical mistrust than those who had received timely breast cancer screening.

“African-American women had the highest levels of mistrust, but most of the women studied in the other groups were also clustered around ‘strongly agreeing’ or ‘agreeing’ with the statement that caution was recommended in dealing with health care organizations,” Williams noted.

Nearly half of the women (49 percent) agreed with the statement, “patients have sometimes been deceived or misled by health care organizations” and 39 percent of African American women did not trust health care organizations to keep their information private. This notion was echoed by 15 percent of Latina women and 9 percent of Arab American women.

This lack of trust led to a lower screening rate. Among the women who had never received a clinical breast exam, 44 percent agreed that “health care organizations have sometimes done harmful experiments without our knowledge.”

In addition, 64 percent of women who had not received a clinical breast exam in the past 12 months agreed with the statement: “Sometimes I wonder if health care organizations really know what they are doing.” Among women who had received a clinical breast exam in the last year, 47 percent agreed with this statement.

“While insurance obviously plays a large role in screening, we can’t ignore that medical mistrust also plays a role,” Williams concluded.

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