Religion,Race,and Breast Cancer Survival

Abstract

Objective:

The study investigated whether any of four measures of religiousness predicted longer survival for 145 African-American and 177 White women diagnosed with breast cancer in Connecticut between January 1987 and March 1989.

Method:

Multivariate Cox proportional hazards models included a religious predictor and sociodemographic, biomedical, treatment, behavioral, and medical care covariables.

Results:

The no denomination group had a hazard ratio (HR) of 4.39 (95% Confidence Interval (CI) = 1.42, 13.64). Other measures of religiousness did not yield statistically significant results but showed a consistent pattern of nonreligiousness being more strongly and negatively related to breast cancer survival in African Americans than in Whites.

Conclusions:

Exploratory models confirmed that lack of religiousness was associated in this sample with poor breast cancer survival among African American women.

Keywords

breast cancer religion race women's health African Americans

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References

Butow

Coates

Dunn

. Psychosocial predictors of survival: Metastatic breast cancer. Annals of Oncology 2000;11(4):469–474.

Cassileth

Lusk

Miller

Brown

Miller

. Psychosocial correlates of survival in advanced malignant disease? New England Journal of Medicine 1985;312(24):1551–1555.

Edwards

Cooper

Pearl

de Paredes

O'Leary

Wilhelm

. The relationship between psychosocial factors and breast cancer: Some unexpected results. Behavioral Medicine 1990;16(1):5–14.

Jamison

Burish

Wallston

. Psychogenic factors in predicting survival of breast cancer patients. Journal of Clinical Oncology 1987;5(5):768–772.

Reynolds

Boyd

Blacklow

Jackson

Greenberg

Austin

Chen

Edwards

. The relationship between social ties and survival among black and white breast cancer patients. National cancer institute black/white cancer survival study group. Cancer Epidemiology, Biomarkers & Prevention 1994;3(3):253–259.

Spiegel

. Psychosocial aspects of breast cancer treatment. Seminars in Oncology 1997;24(1 Suppl. 1):S1–36–S1–47.

Koenig

McCullough

Larson

. Handbook of Religion and Health. New York: Oxford University Press, 2001.

Feher

Maly

. Coping with breast cancer in later life: The role of religious faith. Psycho-Oncology 1999;8(5):408–416.

Jenkins

Pargament

. Religion and spirituality as resources for coping with cancer. Journal of Psychosocial Oncology 1995;13(1–2):51–74.

10.

Musick

Koenig

Hays

Cohen

. Religious activity and depression among community-dwelling elderly persons with cancer: The moderating effect of race. Journals of Gerontology. Series B, Psychological Sciences & Social Sciences 1998;53(4):S218–S227.

11.

Hoke

. Breast cancer: Pastoral crisis intervention. Journal of Pastoral Care 1997;51:331–335.

12.

Mickley

Soeken

. Religiousness and hope in Hispanic and Anglo-American women with breast cancer. Oncology Nursing Forum 1993;20(8):1171–1177.

13.

Ringdal

. Religiosity, quality of life and survival in cancer patients. Social Indicators Research 1996;38(2):193–211.

14.

Yates

Chalmer

St. James

Follansbee

McKegney

. Religion in patients with advanced cancer. Medical & Pediatric Oncology 1981;9(2):121–128.

15.

Zollinger

Phillips

Kuzma

. Breast cancer survival rates among Seventh-day Adventists and non-Seventh-day Adventists. American Journal of Epidemiology 1984;119(4):503–509.

16.

Creagan

. Attitude and disposition: Do they make a difference in cancer survival? Mayo Clinic Proceedings 1997;72(2):160–164.

17.

Spiegel

Bloom

Gottheil

. Family environment as predictor of adjustment to metastatic breast cancer. Journal of Psychosocial Oncology 1983;1:33–44.

18.

Steffen

Hinderliter

Blumenthal

Sherwood

. Religious coping, ethnicity, and ambulatory blood pressure. Psychosomatic Medicine 2001;63(4):523–530.

19.

Lincoln

Mamiya

. The black church in the African American experience. Durham, NC: Duke University Press, 1990.

20.

St. George

McNamara

. Religion, race, and psychological well-being. Journal for the Social Scientific Study of Religion 1984;23:351–363.

21.

Koenig

Cohen

, editors. The Link Between Religion and Health: Psychoneuroimmunology and the Faith Factor. New York: Oxford University Press, 2002.

22.

Koenig

Cohen

George

Hays

Larson

Blazer

. Attendance at religious services, interleukin-6, and other biological indicators of immune function in older adults. International Journal of Psychiatry 1997;27:233–250.

23.

Schaal

Sephton

Thoreson

Koopman

Spiegel

. Religious expression and immune competence in women with advanced cancer. Paper presented at the American Psychological Association, San Francisco, 1998.

24.

Woods

Antoni

Ironson

Kling

. Religiosity is associated with affective and immune status in symptomatic HIV-infected gay men. Journal of Psychosomatic Research 1999;46:165–176.

25.

Jones

Kasl

Curnen

MGM

Owens

Dubrow

. Severe obesity as an explanatory factor for black/ white difference in stage at diagnosis of breast cancer. American Journal of Epidemiology 1997;146(5):394–404.

26.

Jones

Kasl

Curnen

MGM

Owens

Dubrow

. Can mammography screening explain the race difference in state at diagnosis of breast cancer? Cancer 1995;75(8):2103–2113.

27.

Howard

Hankey

Greenberg

Austin

Correa

Chen

Durako

. A collaborative study of differences in the survival rates of black patients and white patients with cancer. Cancer 1992;69:2349–2360.

28.

Hunter

Redmond

Chen

. Breast cancer: Factors associated with stage at diagnosis in black and white women. Black/ white cancer survival study group. Journal of the National Cancer Institute 1993;85(14):1129–1137.

29.

Marty

. Modern American religion: The irony of it all (1893–1919). 4 vols. Vol. 1. Chicago: University of Chicago Press, 1997.

30.

Raboteau

. The Afro-American traditions. In Numbers

Amundsen

, editors. Caring and curing: Health and medicine in the western religious traditions. Baltimore: Johns Hopkins University Press, 1998:554–556.

31.

Beahrs

Henson

Hutter

, editors. Manual for staging of cancer. 3rd ed. Philadelphia: J. B. Lippincott Company, 1988.

32.

Najjar

Rowland

. Anthropometric reference data and prevalence of overweight, United States, 1976–1980, Vital and Health Statistics, Series 11: Data from the National Health Survey, no.238. Hyattsville, MD: National Center for Health Statistics, 1987.

33.

Breast cancer facts and figures, 2000–2001. American Cancer Society, 2001.

34.

Pargament

Smith

Koenig

Perez

. Patterns of positive and negative religious coping with major life stressors. Journal for the Social Scientific Study of Religion 1998;37(4):710–724.

35.

SAS/Stat user's guide, SAS onlinedoc: Version 8. Cary, NC: SAS Institute, 1999.

36.

National Jewish population survey. Council of Jewish Federations, 1990 [cited February 1, 2002. Available from http://web.gc.cuny.edu/dept/cjstu/highint.htm.

37.

Baron

Kenny

. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality & Social Psychology 1986;51(6):1173–1182.

38.

McCullough

Hoyt

Larson

Koenig

Thoresen

. Religious involvement and mortality: A meta-analytic review. Health Psychology 2000;19(3):211–222.

39.

Kaplan

Reynolds

. Depression and cancer mortality and morbidity. Prospective evidence from the alameda county study. Journal of Behavioral Medicine 1988;11:1–13.

40.

Goldbourt

Yaari

Medalie

. Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees. Cardiology 1993;82:100–121.

41.

Gupta

Prakash

Gupta

. Prevalence and determinants of coronary heart disease in a rural population of India. Journal of Clinical Epidemiology 1997;50:203–209.

42.

Oxman

Freeman

Manheimer

. Lack of social participation or religious strength and comfort as risk factors for death after cardiac surgery in the elderly. Psychosomatic Medicine 1995;57:5–15.

43.

Loprinzi

Laurie

Wieand

Krook

Novotny

Kugler

Bartel

Law

Bateman

Klatt

Dose

Etzell

Nelimark

Mailliard

Moertel

. Prospective evaluation of prognostic variables from patient-completed questionnaires. Journal of Clinical Oncology 1994;12(3):601–607.

44.

Kune

Watson

. The Melbourne Colorectal Cancer Study. Incidence findings by age, sex, site, migrants, and religion. International Journal of Epidemiology 1986;15:483–493.

45.

Kasl

Jones

. Some methodological considerations in the study of psychosocial influences on health. In Vingerhoets

, editor. Assessment in behavioral medicine. London: Harwood Academic Publishers, 2001:25–48.

46.

Stark

Bainbridge

. A theory of religion. Paperback ed. New Brunswick, NJ: Rutgers University Press, 1996.

47.

Ransdell

Rehling

. Church-based health promotion: A review of the current literature. American Journal of Health Behavior 1996;20(4):195–207.