Pandemic more worrisome to white breast cancer survivors than Black

COVID-19 has forced delays in many healthcare treatments, causing undue stress on individuals who can least afford more anxiety in their lives, especially those living with cancer. In new research conducted at the University of Illinois Cancer Center, white breast cancer survivors were significantly more worried about the pandemic interfering with their treatment than Black survivors.

“We knew from our previous analysis that disruptions in cancer care due to the pandemic had an impact on all breast cancer survivors, regardless of race,” said Tamara Hamlish, PhD, research scientist at the UI Cancer Center and co-author on the new study published in the Journal of Racial and Ethnic Health Disparities. “We wanted to explore whether there were differences in how Black and white patients experienced those delays, particularly differences in worry about their cancer and cancer care.

“We learned that white breast cancer survivors reported significantly higher rates of emotional distress related to cancer compared to Black survivors. We believe this may be due to white survivors experiencing lower rates of delays in treatment unrelated to the pandemic, and they may not have established strategies to handle the emotional distress of the delays.”

Analyzing the data from 570 adult breast cancer survivors who completed an online survey, Hamlish and co-author Elizabeth Lerner Papautsky, PhD, assistant professor in the Department of Biomedical & Health Information Sciences at the University of Illinois Chicago and a member of the UI Cancer Center’s Prevention and Control program, discovered the importance of assessing racial differences in emotional response to disruptions in cancer care during the pandemic.

“We believe that contrasts in distress levels may reflect differences in previous experiences of treatment delays and coping strategies between the two races,” Hamlish said.

At the time of the survey, more than half of the respondents were currently receiving active cancer treatment (63%) and had employer-sponsored health insurance (67%). Respondents reported being treated at academic medical centers (45%), physician’s offices (26%), or community hospitals (21%). Approximately 42% said they experienced delays in care due to the pandemic. The average age of the respondents was nearly 48, and the sample comprised of 81% white women and 19% Black.

Prior research on racial differences in emotional distress provides insight into emotional response during the pandemic. Perhaps, strategies employed by Black survivors – suppressing emotions, wishful thinking, and positive reappraisal – are more effective in managing distress than those of white survivors – expressing emotions, problem-solving, and escapism – related to delays in care.

“Black communities in the United States have experienced higher rates of COVID-19 infection and mortality and higher risk of changes in employment and income, health insurance, household composition, and other social determinants of health,” Papautsky said. “Black breast cancer survivors may be struggling to balance multiple competing and urgent priorities, making their own health, including delays in cancer care, a lower priority.”