INADEQUATE ADHERENCE TO RADIOTHERAPY IN LATINA IMMIGRANTS WITH CARCINOMA OF THE CERVIX

Background. Radiation therapy plays an important role in the loco-regi onal control of carcinoma of the cervix. Strict adherence to the radia tion protocol, without the introduction of time breaks, has been shown to favorably affect loco-regional control and survival, making adhere nce a crucial variable for optimal outcome. Because carcinoma of the c ervix is a common disease among Latinas, with survival rates worse tha n those of other ethnic groups in this country, the pattern of adheren ce to the prescribed radiation treatment among Latina patients seen at Los Angeles County Hospital were studied. Methods. The records of 69 consecutive Latina patients with cervical cancer who received radiatio n therapy at Los Angeles County Hospital were reviewed. Semistructured interviews in a successive group of 30 similar patients were conducte d to acquire preliminary information about their psychosocial characte ristics. Results. The results demonstrate inferior rates of optimal ad herence to radiation treatment among Latina immigrant patients when co mpared with the rates reported in the literature for the general popul ation of cervical cancer patients in United States (16 vs. 63%). Furth ermore, a large subset of patients (20%) in the series elected to disc ontinue treatment without a medical reason. When a comparable group of Latina patients was interviewed, potential practical, psychologic, an d cultural barriers to optimal care were identified. Conclusions. The results from this exploratory study support the need for further studi es to document the pattern of adherence to radiotherapy in the rest of the country among this minority population. The results suggest that an intervention to improve information and adherence to radiation ther apy may be necessary to assure Latinas a chance for rates of cure comp arable with the national standards.