Possible socioeconomic and ethnic disparities in quality of life in a cohort of breast cancer survivors

Abstract

PURPOSE-This paper describes the ethnic and socioeconomic correlates of psychosocial functioning in a cohort of long-term nonrecurring breast cancer survivors and determines the contribution of ongoing difficulties, including symptoms and concerns about cancer, to the ethnic and socioeconomic differences in functioning levels.METHODS-Participants (n=804) in this study were women from the Health, Eating, Activity, and Lifestyle (HEAL) Study, a population-based, multicenter, multiethnic, prospective study of women newly diagnosed with in situ or Stages I to IIIA breast cancer. Measurements occurred at three timepoints following diagnosis (average 6.1 months following diagnosis, at approximately 30.5 months post diagnosis, at approximately 40.6 months post diagnosis). Outcomes included standardized measures of functioning (MOS SF-36).RESULTS-Overall, these long-term survivors reported values on two physical function subscales of the SF-36 slightly lower than population norms. Black women reported statistically significantly lower physical functioning scores (p=0.01), compared with White and Hispanic women, but higher mental health scores (p<0.01) compared with White and Hispanic women. In the final adjusted model, race was significantly related to physical functioning, with Black participants and participants in the "Other" ethnic category reporting poorer functioning compared to the White referent group (p<0.01, 0.05). Not working outside the home, being retired or

Health-related quality of life in breast cancer survivors of different sexual orientations

“…Survivors treated with adjuvant hormonal therapy, such as tamoxifen, and those with more comorbidities and later stage of disease had worse physical QOL, consistent with earlier findings [6,[37][38][39]. Similarly, as others have shown, lower socioeconomic status [10,11] and being non-White is linked to worse physical health [8][9][10]. A novel finding of this study is the significant association between neighborhood-level socioeconomic status and physical health, indicating that living in neighborhoods with less poverty is related to better physical health scores.…”

“…The survivorship literature points to clinical, social, and cultural factors, as explanations for poor adjustment. Breast cancer survivors who receive systemic adjuvant therapy (chemotherapy, tamoxifen, or both together) [6], who are younger [7], African American [8][9][10] or of lower socioeconomic status [10,11] have lower health-related QOL compared to those without systemic adjuvant therapy, and survivors, who are older, White, and with more socioeconomic resources.…”

Physical activity, long-term symptoms, and physical health-related quality of life among breast cancer survivors: A prospective analysis

“…Eligibility, recruitment, and retention of HEAL participants are described in detail elsewhere (31). Briefly, 1,183 patients diagnosed with their first primary breast cancer were recruited from National Cancer Institute sponsored Surveillance Epidemiology and End Results (SEER) registries in three geographic regions of the United States; New Mexico (n=615), Western Washington (n=202), and Los Angeles County, California (n=366).…”

Employment After a Breast Cancer Diagnosis: A Qualitative Study of Ethnically Diverse Urban Women

“…Ethnic disparities have been demonstrated among breast cancer survivors with respect to cancer stage at diagnosis, survival, morbidity, mortality, and quality of life [7][8][9][10][11][12][13][14][15][16]. Ethnic disparities also exist in the labor market with respect to job type, income earned, and unemployment rates, and these disparities may be exacerbated during periods of economic downturn [17][18][19].…”