Study Suggests What May Influence Black Women's Breast Cancer-Related Distress

Breast Cancer News
April 24, 2014
Nicole Katze, MA, Editor and Manager, Content Development
Reviewed By: 
Page Tolbert, LCSW

Trust in medical care received, age, and positive attitude are factors that may affect risk for anxiety or depression among black women newly diagnosed with breast cancer, researchers found.

Their study, published in Psycho-Oncology, also suggests better screening of cancer-related distress among young women is needed. Compared with their white peers, black women are diagnosed more often with breast cancer at younger ages.

Background and Goals

Women newly diagnosed with breast cancer often report feeling anxious and depressed, common forms of distress. Though studies of cancer-related distress exist, no past studies focused on black women specifically. They also did not explore how cultural and environmental, or contextual, factors impact the degree of distress a woman feels.

Researchers wanted to find out if factors such as age, ease of talking with and trust in providers and values commonly held by women who are black play a role in how much distress they feel after being diagnosed with breast cancer. These values include spirituality, working together, and collectivism, defined as being of the mindset that family turns to one another in times of need, such as after a breast cancer diagnosis. To assess how these values impacted the breast cancer experience, researchers surveyed newly diagnosed women.

For this study, anxiety and depression represent the kinds of distress analyzed. Researches used questions from a survey called the Hospital Anxiety and Depression Scale to assess distress among the women.


Eighty-two black women agreed to take part in the study. All were over age 21, had early-stage breast cancer and had surgery no more than 20 weeks before joining. The researchers asked questions by phone interview to assess each woman’s

  • self-reported symptoms of anxiety and depression
  • level of confidence in her ability to stay positive
  • level of confidence in her ability to make sense of and take part in her care
  • level of trust in the medical system and her medical care
  • reliance on religion
  • family and community support
  • feeling that she could talk at ease with her providers
  • access to the medical services she needed
  • belief in values important to black worldviews, such as the ability to work together

Researchers also collected data on the women’s ages, relationship and employment status, whether they had health insurance and what kind, and their education.


Overall, the survey results showed:

  • Thirty-two percent of the women interviewed had distress levels that were high enough to suggest further distress screening by providers may be helpful
  • Women who believed they could stay positive reported low levels of anxiety and depression.
  • Women 50 years of age and older reported lower levels of depression.
  • Women who reported mistrust of the medical system and their medical care reported greater anxiety.

What This Means for You

This study suggests that as a black woman newly diagnosed with breast cancer trust in your providers and your ability to stay positive may lower your distress. Being older than 50 at diagnosis also may lower your risk of depression. Yet, more research is needed to find out whether these factors actually cause distress or if they simply existed together among a percentage of the women studied.

Results also showed that if you are a woman younger than 50 at the time of diagnosis, you may be at greater risk of becoming depressed. Black women are diagnosed at younger ages more often than their white peers. If you feel sadness is getting hard to manage or that it interferes with your routine, talk with your doctor about being screened for depression so you can get the help you need to feel better.

To learn more about making treatment decisions or about the emotional impact of breast cancer, read our Guide to Understanding Treatment Decisions and Guide to Understanding Your Emotions.

For more information about African-Americans and breast cancer, order a free copy of Getting Connected: African-Americans Living Beyond Breast Cancer.

Sheppard, V, W.K. Harper, F, Davis, K, Hirpa, F, Makambi, K.  The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patientsPsycho-Oncology. 2014; (23): 143-150.

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Emotional Health