Introduction. Studies have shown that cancer survivors are more likely to report having a poor health status when compared to the general population; however, few studies have focused on the impact of cancer on perceived health status among women from disadvantaged health populations (e.g., racial/ethnic minorities, those of lower socioeconomic position [SEP], those with chronic conditions).
Methods. The current study includes 46,726 women with and without a history of cancer from the National Health and Nutrition Examination Survey (NHANES) (1999-2016). Self-reported data were available for race/ethnicity, cancer history, health status, comorbidities, and other sociodemographic factors. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were estimated using multivariable logistic regression for the associations between control/survivor status and odds of perceived health status (poor vs excellent/good/fair [referent]), adjusting for age at interview, education, marital status, body mass index, current smoking status, number of alcoholic drinks/day, physical activity, and insurance status. An additional predictor of cancer type (controls, short-term [≤ 5 years], long-term survivors [≥6 years]) was evaluated. Models were stratified by race, federal poverty line (FPL; at/below, above), education (no college, some college+), and having at least one comorbidity (no, yes). Statistical interactions between these variables and control/survivor status and type of cancer were also examined.
Results. A total of 2,415 (5.2%) women had a history of cancer with breast cancer as the most common site (n=704, 29.2%). While most of the survivors were non-Hispanic white (68.4%), 15.2% were Hispanic, 12.1% were non-Hispanic Black, and 4.3% were additional racial groups. Overall, women with a history of cancer were more likely to report a poor health status (OR, 4.69; 95% CI: 1.87-11.7, p=0.001) compared to controls. By cancer type, the only significant association with poor perceived health status was observed among breast cancer survivors compared to controls (OR, 1.91, 95% CI: 1.21-3.01, p=0.005). In stratified analysis by poverty level, breast cancer survivors were found to report poorer health perceptions specifically if they lived at or below the FPL (p-interaction=0.01). There were no significant interactions between our predictors of interest and race/ethnicity, education, or comorbidity status.
Conclusion. Overall, cancer survivors had higher odds of self-reporting poor health status compared to women without a history of cancer. Poor health perceptions may be particularly important to address among women with a history of cancer living at/below the FPL. Using this information, researchers and clinicians can better tailor health interventions to improve perceived health status among women cancer survivors, particularly among socioeconomically disadvantaged women.
Acknowledgement of Funding. KD was supported by the National Cancer Institute (NCI) Cancer Epidemiology, Prevention, and Control Training Grant (T32CA009314) and MK was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Clinical Research and Epidemiology in Diabetes and Endocrinology Training Grant (T32DK062707).
Citation Format: Kate E. Dibble, Maneet Kaur, Avonne E. Connor. Evaluation of disparities in perceived health status among female cancer survivors in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB080.