The experience of treatment barriers and their influence on quality of life in American Indian/Alaska Native breast cancer survivors

Elizabeth A. Goodwin, Linda Burhansstipanov, Mark Dignan, Katherine L. Jones, Judith Salmon Kaur

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


BACKGROUND: American Indian and Alaska Native (AI/AN) breast cancer survivors experience disparities in breast cancer incidence and age-adjusted mortality compared with non-Hispanic white (NHW) breast cancer survivors. In addition, mortality-to-incidence rates indicate that AI/ANs continue to have the poorest survival from breast cancer compared with other racial groups. “Native American Cancer Education for Survivors” (NACES) is a cultural education and support intervention for AI/AN patients with cancer that collects data from voluntary participants through the NACES quality-of-life (QOL) survey regarding their cancer experience and survivor journey. METHODS: Data from the NACES QOL survey were analyzed to determine whether barriers accessing and during initial cancer treatment impacted QOL domains for AI/AN cancer survivors. Exploratory analyses of selected variables were conducted and were followed by Kruskal-Wallis tests to determine whether these barriers influenced survivorship QOL for AI/AN breast cancer survivors. RESULTS: AI/AN breast cancer survivors' social QOL was significantly affected by barriers to accessing cancer treatment. Many respondents experienced barriers, including a lack of cancer care at local clinics and the distance traveled to receive cancer care. During treatment, too much paperwork and having to wait too long in the clinic for cancer care were the most frequently reported barriers. CONCLUSIONS: Treatment barriers influence AI/AN breast cancer survivors' social QOL. Mediating these barriers is crucial to ameliorating AI/AN survivors' disparities when accessing and completing cancer treatment and improving survivorship QOL. Cancer 2017;123:861–68.

Original languageEnglish
Pages (from-to)861-868
Number of pages8
Issue number5
StatePublished - Mar 1 2017

Bibliographical note

Funding Information:
This study was supported by the National Cancer Institute (NCI) (NCI R25 CA101938; principal investigator, Linda Burhansstipanov), Susan G. Komen for the Cure (POP0202135 and POP0503920; principal investigator, Linda Burhansstipanov), and Mayo Clinic's Spirit of Eagles Community Network Programs 1 and 2 (NCI U01CA114609 and U54CA153605; principal investigator, Judith Salmon Kaur).

Publisher Copyright:
© 2016 American Cancer Society


  • American Indians
  • cancer
  • quality of life
  • survivor
  • treatment barriers

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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