Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;13(3):459-467.
doi: 10.1007/s11764-019-00767-9. Epub 2019 May 20.

Socioeconomic disparities in health-related quality of life among colorectal cancer survivors

Jean A McDougall  1   2   3 , Cindy K Blair  4   5 , Charles L Wiggins  4   5 , Michael B Goodwin  6 , Vi K Chiu  4   5 , Ashwani Rajput  4   7 , Anita Y Kinney  8
Affiliations

Socioeconomic disparities in health-related quality of life among colorectal cancer survivors

Jean A McDougall et al. J Cancer Surviv. 2019 Jun.

Abstract

Purpose: Improvements in colorectal cancer (CRC) prevention, early detection, and treatment have resulted in substantial gains in survival. However, the health-related quality of life (HRQoL) of CRC survivors often depends on access to supportive care, which differs by survivors' socioeconomic characteristics. The purpose of this study was to investigate the relationship between socioeconomic characteristics and HRQoL in a diverse group of CRC survivors.

Methods: We conducted a population-based, cross-sectional study to examine the association between socioeconomic factors (household income, health literacy, and insurance status) and HRQoL domains of pain interference, fatigue, physical function, sleep disturbance, anxiety, and depression. PROMIS® Short Forms v.2.0 were used to assess domains of HRQoL. Linear regression modeling was used to estimate the coefficient representing the average HRQoL domain score and its 95% confidence interval (CI).

Results: Three hundred one CRC survivors participated in the survey. Low-income (≤ $30,000) CRC survivors had, on average, a 4.70-point (95% CI 1.10-8.28) higher pain interference score, a 7.02-point (95% CI 3.27-10.77) higher fatigue score, a 5.13-point (95% CI - 8.56 to - 1.71) lower physical function score, and a 4.44-point (95% 1.40-7.49) higher depression score than CRC survivors with an income ≥ $70,000. Survivors with Medicaid insurance reported significantly greater pain interference and worse physical function than privately insured survivors. Survivors with low health literacy reported significantly greater pain interference compared with survivors with high health literacy.

Conclusions: Substantial socioeconomic disparities in HRQoL were observed in this diverse population of CRC survivors.

Implications for cancer survivors: Designing supportive care interventions to improve HRQoL among low-income and Medicaid-insured CRC survivors is critical for eliminating disparities in CRC outcomes.

Keywords: Cancer; Colorectal; Disparities; Income; Insurance; Survivorship.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors declare that they have no conflicts of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “Silver Tsunami”: Prevalence Trajectories and Comorbidity Burden among Older Cancer Survivors in the United States. Cancer Epidemiol Biomarkers Prev. 2016;25(7):1029–36. doi:10.1158/1055-9965.EPI-16-0133. - DOI - PMC - PubMed
    1. SEER Cancer Statistics Review (CSR) 1975–2014 [database on the Internet]. National Cancer Institute; 2018. Available from: https://seer.cancer.gov/csr/1975_2014/. Accessed: April 11, 2018
    1. Mols F, Schoormans D, de Hingh I, Oerlemans S, Husson O. Symptoms of anxiety and depression among colorectal cancer survivors from the population-based, longitudinal PROFILES Registry: Prevalence, predictors, and impact on quality of life. Cancer. 2018. doi:10.1002/cncr.31369. - DOI - PMC - PubMed
    1. Russell L, Gough K, Drosdowsky A, Schofield P, Aranda S, Butow PN et al. Psychological distress, quality of life, symptoms and unmet needs of colorectal cancer survivors near the end of treatment. J Cancer Surviv. 2015;9(3):462–70. doi:10.1007/s11764-014-0422-y. - DOI - PubMed
    1. Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA et al. Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2012;21(11):2108–17. doi:10.1158/1055-9965.EPI-12-0740. - DOI - PMC - PubMed

Publication types