Fear factor: compliance poor in Hispanic breast ca patients.(Gynecology)

CHICAGO -- Fear, confusion, and mistrust may explain why many Hispanic patients are noncompliant with breast cancer care, Dr. Alexander R. Miller said at the annual clinical congress of the American College of Surgeons.

He explained that nationwide, Hispanics are diagnosed with breast cancer at a later stage and are less likely to hold health insurance than are white women: Both of these factors have been cited as potential reasons for Hispanics' relatively high breast cancer mortality rates.

But at the San Antonio Cancer Institute in a predominantly Hispanic Texas community, "we recognized some problems" with compliance as well, said Dr. Miller of the institute.

He explained that Hispanic women at the clinic were less likely than were whites to undergo mammograms (50% versus 60%) and present more often with stage III or IV breast cancer (37% versus 27%).

In the institute's chemotherapy clinic, which serves primarily indigent Hispanic patients, the no-show rate is 20%, compared with a no-show rate of 8%-10% at a private chemotherapy clinic in the same building that serves mostly whites.

At the university hospital outpatient surgery clinic where the clientele is mostly Hispanic, 21%-44% of patients fail to show up for outpatient surgery, including breast surgery.

At the private hospital directly across the street, the no-show rate for outpatient surgery is 1%-2%.