Abstract
Background: Breast cancer survivors constitute a significant percentage of cancer survivors in the United States, a population that is expected to grow with enhanced surgical procedures, improved cancer therapeutics and new radiation approaches. Although advances in diagnostics and treatment modalities have led to improved quality of life outcomes for breast cancer survivors, evidence suggest that this is not the case for all women. Black women are more likely to be diagnosed with luminal subtypes which are associated with higher mortality rates compared to other women. Additional evidence suggest that Black women experience a multitude of emotional challenges during their breast cancer trajectory which may be further compounded with the burden of chronic stressors coupled with their socioeconomic position (SEP). Given these inequities, the impact of cancer on the lives of black breast cancer survivors (BBCS) is underexplored and warrants further investigation so that we can have a better understanding of their health and well-being over time. To that end, the purpose of this study was to investigate the contribution of psychosocial predictors (SEP, chronic stress burden) on the quality of life in a sample of middle-income BBCS. We hypothesize that higher stress burden would negatively impact life course and higher SEP will positively enhance life course. Methods: A sample of 155 BBCS were recruited using a variety of recruitment strategies, including flyers, direct appeals to BBCS support groups and word-of-mouth across the state of California. Inclusion criteria were women who self-identified as African/Black American, age 25 year or older, diagnosis of breast cancer and at least 1-year post-active treatment. The women completed a demographic data questionnaire, including age, ethnicity, marital status, education, and income and the latter was used to establish SEP. In addition, level of chronic stress was measured with the chronic burden scale (CBS) (Gurung, Taylor, Kemeny, Myers, 2004) and the impact of cancer scale (IOCv2) (Crespi, Ganz, Peterson, Castillo, Caan, 2008) was used to assess quality of life for cancer survivors. Results: The sample of black women were relatively young when diagnosed (mean age at diagnosis 51.67 (SD=10.03).
Most (38%) were married and were homeowners, approximately 48.4% reported having a college degree or higher. Results indicated that education was a significant predictor of quality of life for this cohort R2= .234 and Adjusted R Squared=.088.
These survivors reported low to moderate levels of chronic stress (mean: 25.3), high positive impact of cancer ratings (mean: 4.10), and relatively low ratings of negative impact of breast cancer on their well-being (mean: 2.27). Conclusion: The study findings indicate a more positive quality of life trajectory in middle-class BBCS. Future studies are needed to confirm these results and to test whether there are differences in quality of life trajectory among black women who may differ on chronic stress and SEP.
Citation Format: Claudia M. Davis, Hector F. Myers, Camille I. Davis, Amarachi C. Ihemedu, Nalo Hamilton. The impact of socioeconomic position and chronic stress burden on the quality of life among Black breast cancer survivors in California [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-085.