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

Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Alderman A, Hamilton AS, Graff J, Katz SJ. Racial/ethnic differences in quality of life after diagnosis of breast cancer. Journal of cancer survivorship : research and practice. 2009 Dec 1; 3(4):212-22.

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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.