Ethnicity and persistent symptom burden in breast cancer survivors
- 444 Downloads
Relatively few studies of breast cancer survivors have included nonwhite women or women who do not speak English.
We administered a survey to patients who were ≥3 months post-completion of their adjuvant treatment for stage 0-III breast cancer at Columbia University Medical Center in order to assess the prevalence of 16 physical and emotional symptoms and identify sociodemographic factors associated with these symptoms. Univariate analysis, factor analysis, ANOVA, and multiple linear regression analysis were performed.
Of 139 patients surveyed, 58 were white, 63 Hispanic, and 18 black. The symptom most commonly reported was fatigue(76%), and the most common severe symptom was muscle aches(40%). Most patients(70%) complained of ≥6 symptoms. Hispanic women were more likely to report >10 symptoms (p < 0.05). Factor analysis reduced the 16 symptoms to 4 underlying symptom clusters that we categorized as ‘depression’, ‘chemotherapy’, ‘hormone’, and ‘pain’-related. In the multiple linear regression models, Hispanic women were more likely to report chemotherapy-related symptoms (p < 0.05) and pain-related symptoms (p < 0.05). Unemployed women were more likely to report chemotherapy-related symptoms (p < 0.05). Women <45 years old were less likely to report chemotherapy (p < 0.05) and pain-related symptoms (p < 0.05).
The majority of women in this study, particularly those who were Hispanic, elderly, or unemployed, experienced persistent symptoms, most commonly fatigue and muscle aches.
Implications for cancer survivors
Because Hispanic, elderly, or unemployed women experience greater symptom burden, efforts should made to address their unique needs.
KeywordsBreast cancer survivors Ethnicity Employment Elderly
Olivia Fu did this work as part of a Doris Duke Clinical Research Fellowship. Dr. Hershman is the recipient of a grant from the Susan Komen Foundation (DISP0706868).
- 1.American Cancer Society. Cancer Reference Information. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_people_get_breast_cancer_5.asp; 2009.
- 21.Bernstein R. U.S. Hispanic Population Surpasses 45 Million Now 15 Percent of Total (CB08-67). U.S. Census Bureau Press Releases; 2008.Google Scholar
- 22.Bergman M. Census projects tripling of Hispanic and Asian populations in 50 Years; Non-Hispanic whites may drop to half of total population (CB08-67). U.S. Census Bureau Press Releases; 2004.Google Scholar
- 29.Bergard L. Washington heights/inwood demographic, economic, and social transformations 1990–2005 with a special focus on the Dominican population. Center for Latin America, Caribbean, and Latino Studies; 2008.Google Scholar
- 31.Johnson R, Wichern D. Applied multivariate statistical analysis. 4th ed. New Jersey: Prentice-Hall; 1998.Google Scholar
- 36.Becker A, Thomas JJ, Bainivualiku A, Richards L, Navara K, Roberts AL, et al. Validity and reliability of a Fijian translation and adaptation of the Eating Disorder Examination Questionnaire. Int J Eat Disord; 2009:[Epub ahead of print].Google Scholar
- 50.Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health and disability. J Gerontol Ser A: Biol Sci Med Sci. 2003;58A:82–91.Google Scholar
- 65.Edelman S, Bell DR, Kidman AD. A group cognitive behaviour therapy programme with metastatic breast cancer patients. Psychooncology. 1999;8:292–305.Google Scholar
- 67.Gottlieb BH, Wachala ED. Cancer support groups: a critical review of empirical studies. Psychooncology. 2006;16:379–400.Google Scholar