Abstract
Background: There were an estimated 16.9 million cancer survivors in the United States (U.S.) in 2019. Since this number is projected to increase to over 22 million by 2030 and cancer survivors often face long-term challenges and late effects of treatment, it has become increasingly important to evaluate patients’ health-related quality of life in order to better understand their needs, identify disparities, and develop strategies to improve their overall well-being. Racial/ethnic differences in cancer survivorship have been previously reported, but few have evaluated quality of life among a nationally representative, population-based sample of U.S. patients. Methods: We used self-reported data from the Medical Expenditure Panel Survey (MEPS) as well as its Experience with Cancer Survivorship Supplement questionnaire from 2016-17, which collected information on patient experiences with cancer including quality of life based on the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of physical and mental health. A Global Physical Health (GPH) score using questions related to physical health, physical function, fatigue, and pain and a Global Mental Health (GMH) score using questions related to quality of life, mental health, social support, and emotional problems were calculated where the lower the score indicated the poorer the health. In addition, questions related to whether cancer had a positive impact on patients were considered as well. Multiple logistic regression models with odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the impact of race on these various quality of life/cancer experience outcomes after considering relevant confounders. Results: A total of 1608 cancer survivors (1225 non-Hispanic Whites, 165 Hispanic Whites, 176 Blacks, 42 Asians) were included. When compared to non-Hispanic Whites, only Blacks were statistically significantly more likely to have a low GPH score (OR=1.95, 95% CI 1.15-3.27) and a low GMH score (OR=1.89, 95% CI 1.24-2.89). However, Blacks and Hispanic Whites were statistically significantly more likely to report their cancer experience leading to positive things in their lives; for example, both racial groups were three times as likely to report that their cancer helped them cope better with life’s challenges relative to non-Hispanic Whites (OR=3.66, 95% CI 2.34-5.73 for Blacks, OR=2.91, 95% CI 1.68-5.03 for Hispanic Whites). Conclusions: There are important racial disparities when it comes to health-related quality of life among cancer survivors. Although Blacks were more likely to see the positive aspects of their cancer diagnosis, they still experienced poorer physical and mental health overall. Future studies should explore the factors that may be contributing to these racial disparities as they could greatly inform targeted strategies to improve the overall survivorship experience of cancer patients.
Citation Format: Alice W. Lee, Valerie Poynor, JinKyu Choi. Racial disparities in health-related quality of life among cancer survivors in the United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A038.
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