Factors Influencing Breast Cancer Rates in Utah County

The Federal government initiative Healthy People 2020 has set some cancer-related objectives to reduce late stage diagnosis and death rates for breast cancer. Data predicted that it would take 13 years or more for Utah County to reach these goals. To identify possible explanations for these rates, 16 key informant interviews with breast health practitioners in Utah County were conducted. Questions explored access, utilization, and quality of health services and participants' observations on attitudes and beliefs that may contribute to these findings. Respondents reported that accessibility and quality of breast cancer services in Utah County were excellent. Social services and support for survivors were more limited. Lack of patient and provider knowledge of available resources for low income women could be a barrier. While screening mammograms may be covered by insurance and government programs, a diagnostic work up may not and the expense could create a gap to services. Several explanations for the higher rates were identified. Utilization of screening mammography is low in Utah County which may lead to later stage diagnoses which may lead to a higher death rate. Various factors may be barriers to screening such as fear, finances, feeling too busy, not considering themselves at risk, confusion about guidelines, and over emphasis on family history. Respondents felt that the use of natural and alternative therapies was higher in Utah County and may be associated with poorer outcomes for breast cancer. They also observed a high rate of younger women being diagnosed with breast cancer who were too young for screening and not otherwise considered at risk. These women might also be pregnant or breastfeeding which often created a delay in diagnosis. This project led to several recommendations. Further research could explore the use of natural therapies and outcomes. Utah County is reported to have the youngest population in the nation so providers should be aware that they will see comparatively more breast cancer in younger women. Educational interventions to improve acceptance of screening and to increase awareness of available services should be considered. Health advocacy groups might look into the uncovered costs of a diagnostic evaluation. Limitations to this study include the usual limitations of qualitative data collection such as selection and interview bias, recall error, or selective perceptions. Of the Essentials of Doctoral Education for Advance Nursing Practice, this project met Essentials III, VI, and VII. The aim was to explore prevention and improvement in population wide health outcomes for breast cancer and in relation to the Healthy People 2020 national standards.