Abstract B071: Cultural and structural factors influencing care-seeking delays for abnormal vaginal bleeding among premenopausal Haitian women

Abstract Introduction: Significant racial and ethnic disparities exist in endometrial cancer (EC), particularly among subpopulation Black women. Haitian women specifically have a higher risk for EC with worse survival outcomes. However, little is known about how cultural and structural factors influence care-seeking delays among Haitian women, which can directly impact survival. Cultural beliefs, family dynamics, healthcare mistrust, health insurance and cost barriers, and limited awareness of EC symptoms—such as abnormal vaginal bleeding (AVB)—all shape healthcare-seeking behavior but have been inadequately assessed in this population. Because the incidence of EC in younger women has increased over the last decade, this study explores factors affecting care-seeking among premenopausal Creole-speaking Haitian women experiencing AVB. Methods: We conducted four focus groups with Haitian women (n=19) under the age of 50. Data were coded using NVivo and analyzed thematically, guided by the Andersen Model of Total Patient Delay. Two independent raters identified six key themes related to delay care-seeking. Results: Themes aligned with appraisal, illness, and behavioral delay stages: (1) Awareness and Understanding of Menopause—limited recognition of EC symptoms led to misattribution (e.g., menopause or contraceptive side effects); (2) Information Seeking and Appraisal—participants often relied on self-research or social validation before seeking care; (3) Social Influence on Decisions—family and friends played a key role in prompting or delaying action; (4) Stigma and Taboos—cultural silence around vaginal bleeding discouraged disclosure; (5) Access and Organization—long appointment wait times and perceived bias from providers led to delayed care; (6) Traditional Practices and Beliefs—use of herbal remedies and spiritual healing often preceded biomedical care. Many expressed mistrust toward the medical system and preferred culturally congruent information sources. Conclusions: Care-seeking behavior in premenopausal Haitian women with AVB is driven by the intersection of multiple levels of influence. Strategies to prompt evaluation should include enhanced EC symptom recognition, reduction in stigma, and integration of traditional practices with clinical care. Citation Format: Wilmar B. Mondestin, Maurice J. Chery, LaShae D. Rolle, Alejandra Casas, Sara M. St George, Frank J. Penedo, Kallia Wright, Patricia I. Moreno, Nadine Philogene-Vincent, Sophia HL. George, Matthew P. Schlumbrecht. Cultural and structural factors influencing care-seeking delays for abnormal vaginal bleeding among premenopausal Haitian women [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B071.