Educational differences in responses to breast cancer symptoms: A qualitative comparative study

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Advanced breast cancer diagnosis correlates with lower socioeconomic status (SES).
• Socioeconomic inequalities in breast cancer outcomes persist, particularly in diagnosis stage.
• Limited research exists on the specific patient interval factors driving SES disparities in breast cancer diagnosis.

Purpose of the Study:

• To explore psychosocial factors within the patient interval contributing to socioeconomic disparities in breast cancer diagnosis.
• To understand how women from different educational backgrounds make sense of potential breast cancer symptoms and their help-seeking decisions.
• To identify barriers and facilitators to early healthcare-seeking behavior among women with breast symptoms.

Main Methods:

• Qualitative comparative study utilizing semi-structured interviews.
• Interviewed women (≥47 years) from higher (n=15) and lower (n=15) educational backgrounds.
• Explored symptom interpretation and help-seeking decisions without explicitly mentioning breast cancer.

Main Results:

• Women with lower education attributed symptoms to trivial factors and hesitated to use the word 'cancer'.
• Lack of medical knowledge was cited by lower-educated women as a reason for uncertainty in symptom interpretation and help-seeking.
• Higher-educated women demonstrated confidence in interpreting symptoms, utilizing online information, and seeking medical help.

Conclusions:

• Breast cancer knowledge alone does not explain SES differences in symptom response; psychosocial factors play a significant role.
• Women with lower education exhibited 'reasons' not to seek timely medical attention for breast symptoms.
• Further research is needed to address a broader range of psychosocial factors to mitigate future health inequalities in breast cancer care.