Quality of life of older African American breast cancer survivors: a population-based study
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Factors associated with lower health-related quality of life (HRQOL) among older African American (AA) breast cancer survivors (BCS) have not been elucidated.
Using the Surveillance, Epidemiology, and End Results-Medicare Health Outcome Survey linked dataset, all resected AA BCS over 65 were identified. Using the most recent survey after diagnosis, individuals with a VR12 physical (PCS) or mental (MCS) component score 10 points lower than the median were categorized as having poor HRQOL. Univariate and multivariate (MV) analyses identified predictors of poor HRQOL.
Of 373 AA BCS (median age 74.6), median time from diagnosis to survey was 68.4 months with median follow-up of 138.6 months. Median PCS was 35.9 (IQR 28.5–44.5) with 76 (20.1%) reporting poor PCS. Median MCS was 50.6 (IQR 41.3–59.1) with 101 (27.1%) reporting poor MCS. Predictors of poor PCS included advanced age, larger tumor size, ≥2 comorbidities, inability to perform >2 of 6 activities of daily living (ADLs), modified/radical mastectomy, infiltrating lobular carcinoma, and stage III or IV disease (all p < 0.05). Comorbidities ≥2 and inability to perform >2 of 6 ADLs (p < 0.05) predicted poor MCS. Inability to perform >2 of 6 ADLs was the only independent predictor of poor PCS (OR 10.9, 95% CI 3.0–39.3; p < 0.001) and MCS (OR 7.6, 95% CI 4.3–13.3; p < 0.001).
In elderly AA BCS, poor HRQOL was not associated with socioeconomic status or tumor-specific factors but rather impairment in ADLs.
Physical and mental HRQOL in African American breast cancer survivors is not dependent on socioeconomic or tumor-related characteristics, but rather on inability to perform ADLs.
KeywordsHRQOL African American Breast cancer survivor PCS MCS
Harveshp Mogal: Design of the manuscript, interpretation of data, drafting the article and critical revisions, final approval, and agreement to be accountable for all aspects of the work.
Marissa Howard-McNatt: Interpretation of data, critical revision of the article, final approval, and agreement to be accountable for all aspects of the work.
Rebecca Dodson: Critical revision of the article and final approval.
Nora F. Fino: Analysis and interpretation of the data, critical revisions, and final approval.
Clancy J. Clark: Conceptualization and design, analysis and interpretation of the data, critical revisions, final approval, and agreement to be accountable for all aspects of the work.
Compliance with ethical standards
An Institutional Review Board approval was obtained for the study.
Conflict of interest
The authors declare that they have no conflicts of interest.
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