Racial/ethnic differences in quality of life after diagnosis of breast cancer

Abstract

Introduction: Most studies on quality of life of breast cancer survivors have not had adequate representation of ethnic minorities. The purpose of this study was to determine whether racial/ethnic differences in quality of life exist between white, African American, and Latina women in the early stages of survivorship.

Methods: 2268 women were identified by two Surveillance, Epidemiology and End Results (SEER) registries (6/05-2/07) and asked to complete a survey (mean 9 months post-diagnosis, 72.1% response rate). Latina and African American women were over-sampled. Regression models compared quality of life across race/ethnicity (white, African American, Latina [low vs. high acculturation]), sequentially controlling for sociodemographics, clinical, and treatment factors.

Results: There were significant racial/ethnic differences in quality of life controlling for sociodemographics, clinical factors and treatment factors. Lower acculturated Latinas compared to whites had significantly lower functional well-being, emotional well-being, and breast cancer concerns (p values < 0.05). African Americans had significantly higher emotional well-being than whites. Age, co-morbidities, cancer stage, and chemotherapy also influenced quality of life. A significant interaction was found between race/ethnicity and age for physical well-being (p = 0.041) and for emotional well-being (p = 0.042). Specifically, racial/ethnic differences were only observed among older women (>or=50 years), with less acculturated Latinas reporting the lowest quality of life.

Conclusions: Racial/ethnic differences in quality of life exist during the cancer survivorship period. Latinas with low acculturation are a particularly vulnerable subgroup.

Implications: Greater attention should be devoted to identifying women disproportionately affected by breast cancer and developing interventions targeting their unique survivorship concerns.

Fig. 1

Mean QOL (FACT-B) scores by race/ethnicity Social: (p=0.004); all else (p<0.001); Range of FACT-B scales: Physical, Functional, Emotional, Social (0–28); Breast Concerns (0–40)

Fig. 2

Adjusted Mean Physical and Emotional Well-Being Scores by Race/Ethnicity and Age Note: p-value for interaction between race/ethnicity and age is 0.041 for Physical well-being and 0.042 for Emotional well-being