Date of Award


Degree Name

Doctor of Nursing Science


African Americans, Breast Cancer, Caucasian, military health system, nursing, women


The focus of this descriptive-comparative study was to investigate the relationships between potential access (race, age, socioeconomic status (SES), and the means of discovery of breast cancer), realized access (the length of time between discovery of breast abnormality and diagnosis of breast cancer, and the length of time between diagnosis and initiation of breast cancer treatment), and stage at diagnosis of breast cancer, in African American and Caucasian women, receiving care within an equal economic access health care system. The research questions were answered through secondary analysis, using data obtained from the tumor registry records of 62 African American and 573 Caucasian women diagnosed with breast cancer within the Department of Defense Military Health System, from January 1, 1988 through December 31, 1997. Descriptive statistics were used to describe the sample and the study variables; and independent samples chi-square tests, t-tests, Mann Whitney U tests, analysis of variance, multiple regression, and logistic regression were used to analyze the data. Results indicate that, when compared to Caucasian women, African American women: (a)were diagnosed at a significantly later stage of breast cancer, (b)were significantly younger at the time of diagnosis, (c)were from a significantly lower SES, (d)had a significantly higher percentage of incidental breast self exam (BSE) discovered breast abnormalities, and (e)had a significantly lower percentage of mammogram. discovered breast abnormalities. Women with breast abnormalities discovered by incidental BSE were almost six times more likely to be diagnosed in late stage breast cancer than women with mammogram discovered breast abnormalities. There were no significant differences noted between African American and Caucasian women in length of time between discovery and diagnosis, and length of time between diagnosis and treatment.

Document Type

Dissertation: Open Access



Included in

Nursing Commons