Why Many Breast Cancer Patients Short-Circuit Their Treatment
MONDAY, Nov. 6, 2017 -- Many breast cancer patients skip recommended treatment after surgery because they lack faith in the health care system, a new study indicates.
A patient survey found those who reported a general distrust of medical institutions and insurers were more likely to forgo follow-up breast cancer treatment, such as chemotherapy, hormone therapy or radiation. Trust or distrust of their own doctors did not emerge as a factor.
"If we want more women with breast cancer to complete their treatment, we'll need to deal with their beliefs about the health care system -- and I do think we can modify those beliefs," said study lead author Lorraine Dean. She's an assistant professor of epidemiology at Johns Hopkins University.
Dean's team surveyed more than 2,700 patients in Florida and Pennsylvania after breast cancer surgery. More than 30 percent disregarded their doctor's advice to start or complete follow-up therapy aimed at killing any remaining tumor cells.
Patients who opted out of follow-up treatment were 40 percent more likely to have a cancer recurrence during the two-year study period than those who followed their doctor's recommendations, the researchers found.
"While it is surprising in general that nearly one-third of patients are not following up with recommended adjuvant treatment, some earlier, more localized studies have reported even higher discordance rates, and it's possible that our own figures would have been higher if we had followed patients for more than two years," Dean said in a university news release.
The researchers said their hope is to improve patients' long-term outcomes by boosting rates of adherence to treatment.
"Improving health care system distrust may require strategies that are not solely focused on boosting physician trust," Dean said.
"If ordinary businesses can learn to increase trust in their brands, why not the same with health care institutions?" she concluded.
The study was published recently in the journal Cancer Epidemiology, Biomarkers & Prevention.
The U.S. National Cancer Institute has more on breast cancer.
Posted: November 2017