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Differences between Black and White patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United States)
Authors:Ralph J. Coates  Lorie A. Click  Linda C. Harlan  Stanley Robboy  Rolland J. Barrett II  J. William Eley  Peggy Reynolds  Vivien W. Chen  William A. Darity  Robert S. Blacklow  Brenda K. Edwards
Abstract:To determine whether Black women with symptoms of uterine corpus cancer had longer times from symptom recognition to initial medical consultation than did White women in the United States, 331 newly diagnosed patients living in Atlanta (GA), New Orleans (LA), and San Francisco/Oakland (CA) during 1985–87 were interviewed to collect information on symptoms, dates of recognition and consultation, and other factors that might affect the interval. Data were analyzed to estimate medical consultation rates and rate ratios following sysptom recognition. Median recalled times between symptom recognition and consultation were 16 days for Black women and 14 days for White women. Although poverty, having no usual source of healthcare, and other factors were associated with lower consultation rates, the adjusted rate among Black women was only somewhat lower (0.87) than among White women, and the 95 percent confidence interval (CI=0.58–1.31) was consistent with no true difference between the races. In addition, the median time to consultation for women with stage IV cancer was only 15 days longer than the time (14 days) for the women with stage I cancer. These results suggest that time from symptom recognition to initial medical consultation does not contribute importantly to the more advanced stage cancer of the uterine corpus commonly found among Black women.Drs Coates and Eley and Ms Click are with the Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, GA (USA). Authors are also with the Division of Cancer Prevention & Control, National Cancer Institute, Rockville, MD (Drs Harlan and Edwards); Department of Pathology Obstetrics and Gynecology, Duke University Medical Center, Durham, NC (Dr Robboy); Forsyth Medical Park, Winston-Salem, NC (Dr Barrett); Environmental Epidemiology Section, California State Department of Health Services, Emeryville, CA (Dr Reynolds); Department of Pathology, Louisiana State University Medical Center, New Orleans, LA (Dr Chen); School of Public Health, University of Massachusetts, Amberst, MA (Dr Darity); Office of the President, Northeastern Ohio Universities College of Medicine, Rootstown, OH (Dr Blacklow). Address correspondence to Dr Coates, Department of Epidemiology, Rollins School of Public Health of Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA. This research was supported in part by contracts N01CN-35042-46, N01CN-05227, N01CN-45174, and N01CN-45176 from the National Cancer Institute, US National Institutes of Health.
Keywords:Blacks  health behavior  health services accessibility  race  United States  uterine neoplasms  women
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