A Cultural Model Case for Survivorship Care: Breast Cancer in Hispanic Women

Hispanics represent the largest and fastest-growing ethnic minority in the United States, and their numbers are expected to triple by 2050.¹ Their experience with cancer has been increasingly chronicled in the past decade, especially in relation to their heightened incidence and mortality rates and low participation in cancer screening and prevention efforts.

In particular, breast cancer is a major concern. It is the most commonly diagnosed malignancy and the leading cause of cancer death among Hispanic women in the US, and more than 100,000 Hispanic women are living as breast cancer survivors.^2,3 Despite the prominence of cancer within the Hispanic community, survivorship research is sparse.⁴ Recently, however, a compilation of the empirical literature on health-related quality of life of Hispanic breast cancer survivors has been published.⁵

The following influences were delineated as important correlates of quality-of-life outcomes in the Hispanic subset of breast cancer survivors.⁵

• Intrapersonal (i.e., health status, age, degree of overall well-being)
• Interpersonal (i.e., availability of social networks and social support)
• Community (i.e., degree of social deprivation and unemployment)
• Institutional (i.e., costs and language barriers)
• Public policy (i.e., funding)

Dr. Amelie Ramirez, founding director of the Institute for Health Promotion Research at the University of Texas Health Science Center in San Antonio, also found that depression was a critical factor in noncompliance with ongoing screening and surveillance in Hispanic breast cancer survivors.⁶

She said healthcare providers have two important learning agendas. They need to help survivors understand the importance of becoming more involved in their healthcare. They also need to be sensitized to the prominence of depression in Hispanic breast cancer survivors and design interventions for those struggling with a mood disorder.

Research to date poignantly begins to suggest that culturally prescribed influences must be considered when developing resources and interventions that enhance the quality of survival of Hispanic cancer survivors and perhaps other ethnic minorities. This will grow in importance in the coming years as the face of the American public becomes increasingly diverse and less characterized by a Caucasian majority. Cultural competence within all aspects of oncology nursing will be a necessity, not an isolated geographic luxury.

Did you know…
According to the Census Bureau, the following states have the largest Hispanic populations.

• New Mexico: 47%
• California and Texas: 37%
• Arizona: 31%
• Nevada: 26%
• Florida: 22%
• Colorado: 20%