Health-related quality of life in elderly black and white patients with cancer: results from Medicare managed care population

Abstract

Objective: To compare differences in various aspects of health-related quality of life (HRQOL) between Black and White individuals diagnosed with cancer.

Design: The data were extracted from 2005-2007 Medicare Health Outcome Survey, a health outcomes measure for the Medicare population in managed care settings. A total of 14089 Black and White respondents aged > or = 65 with cancer were included in the study. Multivariable linear regressions were used to assess the association between race and the HRQOL after accounting for age, sex, education years, marital status, and non-cancer comorbid conditions.

Results: When compared with their White counterparts, Black patients had lower scores for the physical component summary (PCS) and mental component summary (MCS), and all health domains with the exception of vitality. After adjusting for demographic features and comorbid conditions, the MCS scores of Black patients were still lower than that of White patients. However, the mean PCS was not different for Black and White patients. Black patients had significantly lower HRQOL in general health, social functioning, and role emotion, whereas they had a higher mean score in vitality.

Conclusions: Race had a significant impact on quality of life for older cancer patients. The effect was likely to be moderated by comorbid conditions and socioeconomic indicators. To optimize cancer outcomes at the population level, it is important to identify subgroups of cancer patients with an increased risk of low quality of life and to develop appropriate supportive interventions of cancer care.