Provider effects and racial inequities in breast cancer risk-management adoption: Findings from a community-based study of high-risk women.
Kaleb Masterson, Jeremy B Straughn, Sam Feudo and 1 others
PMID 41092547WHAT IT FOUND
High-risk women who had a long relationship with a provider, discussed breast cancer risk, or saw a specialist were more likely to follow screening guidance and know prevention options.
Black women reported less access to all three.
Key findings
01Women who had discussed breast cancer risk with a primary care or women's health provider were more likely to be concordant with screening guidelines and aware of preventive options.
02Black women were less likely than White women to have a long provider relationship, see a specialist, follow screening guidelines, or know about preventive options.
03Women with a known BRCA mutation were much more likely to report having discussed breast cancer risk, seen a specialist, and been concordant with screening guidelines.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were cross-sectional, so the paper cannot show that longer provider relationships, risk conversations, or specialist visits caused better screening concordance or awareness. All provider-related factors and outcomes were self-reported by participants. The sample included only non-Hispanic White and non-Hispanic Black or African American women, so it cannot speak to other racial and ethnic groups. Most participants were recruited from nonclinical sources, and many had not received specialist care for breast cancer risk. The authors used complete-case analysis and could not control for race by adding it to models or stratifying due to sample size limitations. Some associations were not statistically significant or only marginally significant, including MRI concordance with longer provider relationships, preventive mastectomy awareness with longer provider relationships, and breast cancer risk discussion by race. The authors could not fully explore the interaction between known BRCA mutation status and race.
The easy way to misread this
Do not read these associations as proof that a longer provider relationship, a risk conversation, or a specialist visit causes better screening or prevention awareness. The study was cross-sectional and self-reported, so it cannot establish the direction or cause of the associations.