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Association of externalizing religious and spiritual beliefs on stage of colon cancer diagnosis among black and white multicenter urban patient populations
Author(s) -
Polite Blase N.,
CiprianoSteffens Toni M.,
Hlubocky Fay J.,
JeanPierre Pascal,
Cheng Ying,
Brewer Katherine C.,
Rauscher Garth H.,
Fitchett George A.
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31351
Subject(s) - medicine , odds ratio , confidence interval , stage (stratigraphy) , colorectal cancer , cancer , disease , multivariate analysis , demography , gerontology , paleontology , biology , sociology
BACKGROUND This study explores whether externalizing religious and spiritual beliefs is associated with advanced‐stage colon cancer at initial oncology presentation and whether this association is stronger for blacks than for whites. METHODS Patients who had newly diagnosed, invasive colon cancer were recruited at 9 sites in the Chicago metropolitan area. Eligible patients were non‐Hispanic white or black, ages 30 to 79 years, and diagnosed with a primary invasive colon cancer. Patients were interviewed on prior screening and diagnosis. Social and attitudinal constructs were measured, including the God Locus of Health Control (GLHC) and Religious Problem Solving. The final response rate was 52% and included 407 patients. RESULTS The median age was 59 years (range, 30‐79 years), and 51% of participants were black. Cancer stage was available for 389 (96%) patients and was divided between late stage (stages III‐IV; 60%) and early stage (stages I‐II; 40%). Multivariate analysis indicated that patients in the highest tertile of scores on the GLHC were more likely have an advanced stage of disease at presentation (odds ratio, 2.14; 95% confidence interval, 1.00‐4.59; P = .05) compared with those in the lowest tertile. No significant interaction was identified between race and GLHC scores for stage at presentation ( P = .78). CONCLUSIONS In a large sample of black and white individuals across diverse health care systems, higher scores on the GLHC predicted late disease stage at presentation. Although blacks had significantly higher GLHC scores, race was not associated with stage at presentation, nor was the association between GLHC and stage limited to blacks. Further work is needed to better understand this association and to develop interventions to better connect the religious and health care spheres. Cancer 2018;124:2578‐87. © 2018 American Cancer Society .