Browsing by Author "Hayes, Lisa"

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    Challenges Experienced by Black Women with Breast Cancer During Active Treatment: Relationship to Treatment Adherence
    (Springer Nature, 2023) Bigatti, Silvia M.; Weathers, Tess; Hayes, Lisa; Daggy, Joanne; Social and Behavioral Sciences, School of Public Health
    Background: Although rates of death from breast cancer have declined in the USA for both Black and White women since 1990, mortality rates for Black women remain strikingly higher - 40% higher compared to White women (American Cancer Society 1). The barriers and challenges that may be triggering unfavorable treatment-related outcomes and diminished treatment adherence among Black women are not well understood. Methods: We recruited 25 Black women with breast cancer who were to receive surgery and chemotherapy and/or radiation therapy. Through weekly electronic surveys, we assessed types and severity of challenges across various life domains. Because the participants rarely missed treatments or appointments, we examined the impact of severity of weekly challenges on thoughts of skipping treatment or appointment with their cancer care team using a mixed-effects location scale model. Results: Both a higher average severity of challenges and a higher deviation of severity reported across weeks were associated with increased thoughts on skipping treatment or appointment. The correlation between the random location and scale effects was positive; thus, those women that reported more thoughts on skipping a dose of medicine or appointment were also more unpredictable with respect to the severity of challenges reported. Conclusions: Black women with breast cancer are impacted by familial, social, work-related, and medical care factors, and these may in turn affect adherence to treatment. Providers are encouraged to actively screen and communicate with patients regarding life challenges and to build networks of support within the medical care team and social community that can help patients successfully complete treatment as planned.
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    Racial disparities in cascade testing for cancer predisposition genes
    (Elsevier, 2023-07) Kassem, Nawal M.; Althouse, Sandra K.; Monahan, Patrick O.; Hayes, Lisa; Nielsen, Sarah M.; Heald, Brandie; Esplin, Edward D.; Hatchell, Kathryn E.; Ballinger, Tarah J.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    We sought to determine whether there are racial disparities in cascade testing rates and whether providing testing at no-charge impacts rates in Black and White at-risk-relatives (ARR). Probands with a pathogenic/likely pathogenic germline variant in a cancer predisposition gene were identified up to one year before and up to one year after cascade testing became no-charge in 2017. Cascade testing rates were measured as the proportion of probands who had at least one ARR obtain genetic testing through one commercial laboratory. Rates were compared between self-reported Black and White probands using logistic regression. Interaction between race and cost (pre/post policy) was tested. Significantly fewer Black probands than White probands had at least one ARR undergo cascade genetic testing (11.9% versus 21.7%, OR 0.49, 95% CI 0.39–0.61, p < 0.0001). This was seen both before (OR 0.38, 95% CI 0.24–0.61, p < 0.001) and after (OR 0.53, 95% CI 0.41–0.68, p < 0.001) the no-charge testing policy. Rates of an ARR undergoing cascade testing were low overall, and significantly lower in Black versus White probands. The magnitude of difference in cascade testing rates between Blacks and Whites did not significantly change with no-charge testing. Barriers to cascade testing in all populations should be explored in order to maximize the benefits of genetic testing for both treatment and prevention of cancer.