Everyday discrimination and telomere length in a multiethnic cohort of breast cancer survivors

Aghaee, Sara; Allen, Amani M.; Ramirez, Julio; Shariff‐Marco, Salma; Allen, Laura; DeRouen, Mindy C.; Elmofty, May; Márquez-Magaña, Leticia; Gomez, Scarlett Lin

doi:10.1080/13557858.2020.1739231

Cited by 4 publications

(11 citation statements)

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“…There are many studies linking discrimination and health, 6,8,15,16,50 but fewer that have examined how discrimination affects aging or biomarkers of aging processes, 51–53 and only one small, inconclusive study of discrimination and an aging marker in breast cancer survivors 18 . In addition to a relative paucity of data, the relationships between experiences of discrimination, aging and health outcomes are not straightforward.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to a relative paucity of data, the relationships between experiences of discrimination, aging and health outcomes are not straightforward. There are reports that low income, passive coping styles, internalized racism, and medical mistrust can exacerbate the negative effects of discrimination on health among African American individuals 18,54 . These relationships have not been studied in the context of aging and cancer survivorship and will be important to consider in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we did not have data on specific biomarkers of aging processes that might illuminate the pathways between experiences of discrimination and frailty and other cancer survivorship outcomes. This will be an important next step 18 . Second, although the items in our measure of major discrimination has been used over decades and predicts mental and physical health outcomes, 7,45,50,52,59 it may not reflect all types of discrimination in current society.…”

Section: Discussionmentioning

confidence: 99%

“…In noncancer settings, many factors affect aging, health, and health disparities, such as harmful environmental exposures, limits in community resources, socioeconomic opportunity and health care access, and experiencing discrimination 1,5–9 . Factors like discrimination are thought to affect aging via chronic stress, upregulation of stress responses, chronic increases in inflammation, shortening of telomeres, and loss of homeostasis in biological systems 1,10–19 . Thus, it is possible that experiences of discrimination could explain some of the observed racial disparities in cancer outcomes, including poor age‐related function and high cancer‐specific and all‐cause mortality 18,20 …”

Section: Introductionmentioning

confidence: 99%

“…There are virtually no studies of the relationships between discrimination and aging in the setting of cancer survivorship 18 . This gap is exacerbated by the continued under‐representation of racial and ethnic minorities in cancer research, 21 difficulties measuring aging in oncology settings, and observations that levels of frailty, which are thought to reflect aging, are not always clinically apparent 22–24 .…”

Section: Introductionmentioning

confidence: 99%

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Association between major discrimination and deficit accumulation in African American cancer survivors: The Detroit Research on Cancer Survivors Study

Mandelblatt

Ruterbusch

Thompson

et al. 2023

Cancer

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Background: Discrimination can adversely affect health and accelerate aging, but little is known about these relationships in cancer survivors. This study examines associations of discrimination and aging among self-identified African American survivors. Methods: A population-based sample of 2232 survivors 20-79 years old at diagnosis were enrolled within 5 years of breast (n = 787), colorectal (n = 227), lung (n = 223), or prostate (n = 995) cancer between 2017 and 2022. Surveys were completed post-active therapy. A deficit accumulation index measured agingrelated disease and function (score range, 0-1, where <0.20 is robust, 0.20 to <0.35 is pre-frail, and 0.35+ is frail; 0.06 is a large clinically meaningful difference).The discrimination scale assessed ever experiencing major discrimination and seven types of events (score, 0-7). Linear regression tested the association of discrimination and deficit accumulation, controlling for age, time from diagnosis, cancer type, stage and therapy, and sociodemographic variables.Results: Survivors were an average of 62 years old (SD, 9.6), 63.2% reported ever experiencing major discrimination, with an average of 2.4 (SD, 1.7) types of discrimination events. Only 24.4% had deficit accumulation scores considered robust (mean score, 0.30 [SD, 0.13]). Among those who reported ever experiencing major discrimination, survivors with four to seven types of discrimination events (vs. 0-1) had a large, clinically meaningful increase in adjusted deficits (0.062, p < .001) and this pattern was consistent across cancer types. Conclusion:African American cancer survivors have high deficit accumulated index scores, and experiences of major discrimination were positively associated with these deficits. Future studies are needed to understand the intersectionality between aging, discrimination, and cancer survivorship among diverse populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%