Eva sadly remembers how her doctor belittled her concerns about a dough in her chest, a story that seems to be repeated in racially and economically segregated neighborhoods, where Hispanics are much more likely to receive a diagnosis of breast cancer or uterine neck in advanced stages, according to a study by the American Cancer Society (ACS).
“He told me (the family doctor) that this was nothing,” said Eva, a Puerto Rican resident in the Bronx (New York) about the difficulties she faced to be diagnosed with breast cancer in stage three.
At that time, the Latin was convinced that the cramp and the pain he suffered after touching the dough under her left breast were the sign of “something serious.” That feeling was the one who made him face his doctor and demand that he take an exam.
“I don’t care what you say, my body tells me a different thing, you do my studies or call me your supervisor,” evokes the Hispanic with bitterness about the debate with your doctor.
Eva is not the only Latin who has faced obstacles to obtaining the diagnosis, according to the results of a study published in the Journal of the National Cancer Institute (JNCI).
The investigation, which analyzed almost 100,000 cases of the New York state cancer registration between 2008-2019, showed that structural barriers in the segregated neighborhoods continue to delay the diagnosis of breast cancer and cervix, even among the eligible people for detection, according to Qinran Liu, postdoctoral researcher in the ACS and main author of the study.
Segregation influences diagnosis
This research is the first to use census districts (the most granular geographical level available in cancer records) to examine how racial economic segregation influences the diagnosis in the advanced stage of the three main types of cancer, (breast, uterine and colorectal neck) simultaneously detectable.
In each case of cancer analyzed, the researchers were assigned a neighborhood segregation score and were classified into four categories, from least to greater segregation, to compare the incidence rates of early and late cancer cancer diagnoses.
The results of the study showed that the incidence rates (IT) for both breast cancer and cervix in advanced and located stages were significantly higher in areas with low economic resources and with high racial concentration (either of the black or Hispanic black population) compared to the richest areas of the same population.
And, the analysis of the data suggests that in general the support networks in the Hispanic neighborhoods “could mitigate” the adverse health effects that are usually associated with racial segregation.
“These communities can provide protective effects through culturally appropriate health programs, psychosocial support and community participation that promote medical care behaviors and facilitate early diagnoses,” Liu said.
Health barriers
However, in the economically disadvantaged Hispanic neighborhoods facing structural barriers, such as lower medical insurance coverage and financial challenges, a decrease in possible protective effects associated with the high concentrations of Hispanics was observed.
“These barriers are aggravated by linguistic isolation and immigration -related challenges, which further restrict the search for medical care by low -income people of Hispanic origin and hinder navigation in the health system,” says the researcher.
Eva, 61, is concerned that more Hispanas face a situation similar to her.
“It was not only the diagnosis, they did not call me to explain that I had cancer, they sent me directly to the chemotherapies, and that was where the doctor told me that I was already reaching my throat, that is not fair,” says the Puerto Rican who has lived most of her life in the New York county of the Bronx.
In that sense, Liu warns that these findings provide health systems and those responsible for the formulation of evidence to direct bilingual dissemination, patient orientation and insurance and cost assistance to the most needy communities.
“Recognizing both risk and resilience helps design personalized interventions according to the needs of each community,” he adds.
On the other hand, Eva, who has been in remission for several years but with a checkpoints every six months, encourages Hispanics to seek help, and not “let themselves be overcome” by the obstacles of the system.
