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Outside the Lab Cancer, Public health

Trust Me, I’m a Doctor

As many as a third of US patients with breast cancer could be avoiding treatments recommended by their doctors, because of a mistrust in healthcare institutions, according to a recent study (1).

A survey of 2,754 women from Florida and Pennsylvania followed over two years found that 30.2 percent reported either not beginning, or not continuing with, at least one recommended adjuvant therapy following breast cancer surgery. Lead author Lorraine Dean was not entirely shocked, noting in a press release (2): “While it is surprising in general that nearly one-third of patients are not following up with recommended adjuvant treatment, some earlier, more localized studies have reported even higher discordance rates, and it’s possible that our own figures would have been higher if we had followed patients for more than two years.”

Non-adherence to treatment was also linked to higher incomes, an earlier cancer stage, and living in Florida (a state in which insurance laws cover a second opinion following diagnosis). The findings also suggested that non-adherence wasn’t associated with how much a patient trusted their individual doctor but, rather, a mistrust of the healthcare system as a whole.

Perhaps the most important finding was the effect that non-adherence had on health outcomes: patients who reported non-adherence to parts of their treatment were 40 percent more likely to see their cancer recur within the two year period covered by the study.

The study authors suggest that healthcare systems might look to the strategies of other large institutions to tackle the mistrust some patients feel. Said Dean, “If ordinary businesses can learn to increase trust in their brands, why not the same with health care institutions?”

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  1. LT Dean et al., “Healthcare system distrust, physician trust, and patient discordance with adjuvant breast cancer treatment recommendations”, Cancer Epidemiol Biomarkers Prev, cebp.0479.2017 [Epub ahead of print] (2017). PMID: 28971987.
  2. Johns Hopkins Bloomberg School of Public Health, “Breast cancer patients forego post-surgery treatment due to mistrust, study suggests”, (2017). Available at: Accessed November 17, 2017.
About the Author
Roisin McGuigan

I have an extensive academic background in the life sciences, having studied forensic biology and human medical genetics in my time at Strathclyde and Glasgow Universities. My research, data presentation and bioinformatics skills plus my ‘wet lab’ experience have been a superb grounding for my role as a deputy editor at Texere Publishing. The job allows me to utilize my hard-learned academic skills and experience in my current position within an exciting and contemporary publishing company.

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