Year of Publication

2016

College

Public Health

Date Available

4-22-2016

Degree Name

Master of Public Health (M.P.H.)

Committee Member

Lorie Chesnut, DrPH, MPH

Advisor

Ann Coker, MPH, PhD

Co-Director of Graduate Studies

Daniela Moga, MD, PhD

Abstract

Background: Treatment delays have been linked to decreased survival in women with breast cancer. Many women rely on their spouse or partner to provide support following breast cancer diagnosis. To date, little research has explored the effects of partner supportive behaviors on timely receipt of recommended cancer treatment and ultimately cancer survival.

Objective: To determine whether women identified as having lower partner support experience delays in time to first breast cancer treatment relative to women with highly supportive partners.

Methods: Women aged 18-79 who were diagnosed with incident and primary breast cancer within the past 12 months and included in the Kentucky Cancer Registry were recruited for the cohort study between November 2009 and December 2013. The new measure of Partner Supportive Behaviors in Cancer Care (5 item short form) was used to determine women’s recall of partner supportive behaviors during and after cancer treatment and recovery. Unadjusted and adjusted linear regression, Kaplan-Meier, and Cox-Proportional Hazard modeling were used to determine the relationship between partner support and time to first treatment for women with breast cancer.

Results: Lower partner support was not significantly associated with longer time to first treatment for women with breast cancer, relative to women with highly supportive partners. Time to first treatment among 94 women with lower partner support was 22.2 days (SE: 1.9), compared to 21.7 days (SE: 1.5) for 144 women with moderate partner support, and 21.4 days (SE: 0.8) for women with highly supportive partners. The adjusted hazard ratio for those with lower partner support was 0.95 (95% CI: 0.76-1.18). This 4 pattern held for analyses of time to first cancer treatment independent of treatment type, by specific treatment (surgery and chemotherapy), and for analyses within early and late cancer stage.

Conclusions: To our knowledge, no other studies have examined the association between partner support and time to first cancer treatment. Future studies may consider the effect of other negative partner behaviors such as intimate partner violence or behaviors interfering with cancer care that may directly impact timely receipt of cancer treatment.

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