Study Finds Racial Differences in Choices for Breast Cancer Care

Blacks, Hispanics more likely to be guided by referrals, health plan limits

THURSDAY, March 19, 2015 (HealthDay News) -- When it comes to choosing a surgeon and hospital for breast cancer treatment, white patients are more likely to make their selection based on reputation than black and Hispanic patients are, a new study shows.

The findings suggest that minority patients may be more dependent on doctor referrals and health plan limitations when making those decisions, the researchers said.

"Most women relied on referrals from their physicians for selecting surgeons, particularly black women and Spanish-speaking Hispanic women," Dr. Rachel Freedman, of the Dana-Farber Cancer Institute in Boston, and colleagues wrote.

"In addition, minority patients were less likely to report reputation as an important component of their decisions about surgeons and hospitals, and were more likely to select a hospital because it was part of their health plan," according to the study authors.

The study included 500 breast cancer patients from northern California. Of these, 222 were white, 142 were black, 89 were English-speaking Hispanic women and 47 were Spanish-speaking Hispanic women.

A doctor's referral was the most common reason for selecting a surgeon (78 percent), the study found. The most common reason for choosing a hospital was that the hospital was part of a woman's health plan (58 percent).

Thirty-two percent of white patients selected a surgeon based on reputation, compared with only 22 percent of Hispanic patients and 18 percent of black patients. White patients were also more likely than Hispanic and black patients to choose a hospital based on reputation -- 23 percent, 15 percent, and 7 percent, respectively, according to the findings published online March 19 in the journal JAMA Oncology.

A large percentage of women in the study were insured by Kaiser Permanente. That may explain why many said their health plan guided their selection, the study authors suggested in a journal news release.

"These findings suggest less-active involvement of minority patients with regard to selecting physicians and hospitals for their care," Freedman and colleagues concluded.

According to background information in the study, patient involvement in choosing hospitals and doctors may be a factor in racial and ethnic disparities in care.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

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