Abstract A49: Quality of life in lower income, primarily African American, cancer survivors

Introduction: While racial/ethnic cancer health disparities in incidence, treatment, and mortality are well documented, the psychosocial characteristics of underserved, minority cancer survivors are poorly understood. In this study, we explore quality of life in lower income, primarily African American survivors in treatment or follow-up for a first cancer diagnosis.

Methods: We examined baseline data from an intervention trial conducted in a safety net hospital in Alabama. Health related quality of life (QOL) was measured by three subscales of the Functional Assessment of Cancer Therapy-General Scale (FACT-G): social/family well being (SWB, scale range 0 – 28), functional well-being (FWB, scale range 0 – 28) and emotional well-being (EWB, scale range 0 – 24). QOL subscales for the total sample were examined by using t-score conversions to obtain a normative comparison to a reference group of 2236 adult cancer patients (mean of 50 and range of 0 – 100; Bruckner et al., 2005). Regression analyses were conducted to examine the relation between QOL subscales and potential correlates including age, marital status, education, cancer type and time since diagnosis.

Results: At the time of this analysis, a total of 106 participants were enrolled in the study. Of these, 72 (67.9%) were female and 82 (77.4%) were African American. The mean age was 53 years (±10) and 81 (76.4%) had up to 12 years of education. The average annual income was less than $10,000. The most common cancer diagnoses were breast (36.8%) and colorectal (15.1%) cancer. The mean time since diagnosis was 28.5 months. On the FACT subscales, participants reported a mean of: 22.0 ±5.8 on SWB; 17.1 ±7.3 on FWB; and 19.1 ±4.8 on EWB, with higher scores suggesting greater well-being. Converting the FACT-G subscales to t-scores yielded respective SWB, FWB and EWB scores of 49.8, 47.2 and 50.1. Of potential correlates entered into the regression models for SWB, EWB and FWB, only older age was significantly associated with better FWB (p = .05) and longer time since diagnosis was significantly associated with better SWB (p = .05).

Conclusions: Quality of life subscales SWB, FWB and EWB for these lower income, predominantly African American cancer survivors compare well to the more heterogeneous reference group of adult cancer patients, especially for older survivors and those further away from diagnosis. These findings suggest the need for further research to identify the characteristics contributing to QOL success. It also suggests further research into the use of the FACT-G in this population as it may not adequately measure the quality of life domains of poor cancer survivors.