Reducing ethnic inequalities for Black women with breast cancer: the role of treatment uptake, engagement and support (REFORM)

Black women are less likely to get breast cancer than white women, however they often have worse outcomes and can be less likely to survive, even when considering health- related or social factors. Lower engagement with adjuvant endocrine therapy (ET), also known as hormone therapy, may be contributing to these disparities in women with hormone receptor positive breast cancer. Taking ET for 5-10 years can reduce the risk of breast cancer returning and becoming incurable. However research from USA indicates that Black women may be less likely to take their hormone therapy as prescribed than white women. Having said this, these studies may have limited application to the UK due to differences in culture and healthcare systems. Initial research from the UK supports these findings, but further investigation into differences between ethnicities in the way women take their hormone therapy is needed within the UK context. Furthermore, the factors causing these differences, have not yet been explored. Therefore, the aim of this research is to explore Black women's experiences with and perspectives of hormone therapy and compare their levels of treatment engagement to those of white women with breast cancer, to identify specific factors associated with low engagement. This will be achieved using questionnaires and interviews. These findings will help us understand better ways to support Black women with breast cancer and help to create targeted support materials to fit their needs, with the aim of improving their breast cancer care, treatment experiences and outcomes.