Abstract A60: Preliminary findings from the Southern Community Cancer Survivorship Study: Disparities in late effects, Part 1
Authors: Flores Ann M. , Dietrich Mary , Blot William J. 
Published: December 2010

Purpose: The purpose of this study is to describe preliminary findings of breast cancer specific physical and functional limitations among African Americans (AAs), whites (Ws), poor, and medically underserved breast cancer survivors (BCS) living in the Southern United States.

Methods and Data: We partner with the Southern Community Cohort Study (SCCS) and are enrolling SCCS participants who are breast cancer survivors. We have enrolled 320 individuals who have completed our computer-assisted telephone interview (CATI). Over 80% were originally recruited by the SCCS from community health centers and the remainder was recruited from the general population. All are enrolled from the 12 states included in the SCCS (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia). The survey focuses on breast cancer specific physical and functional recovery after treatment. We report the preliminary findings on variables related to sociodemographics, range of motion, lymphedema signs and symptoms, and cancer treatment. We use descriptive statistics and Chi-square tests of independence to summarize our preliminary data.

Results: Of our 313 AA or W participants, 49.2% are AAs. Slightly more than half of both groups (AA:53%, W:56%, p=.603) had more than a HS equivalent education. The Ws tended to be older on average (M=66.0, SD=8.6 years) than the AAs (M=62.8, SD=8.3 yrs, p=.001).A higher proportion of AAs than Ws tended to be the primary financial provider of the household (71.4% vs. 53.5%, p = .001), earn $30,000 or less per year (73.4% vs. 54.7%, p = .001), and reported to be on disability (29.2% vs. 11.9%, p &lt; .001), Approximately 17% of participants have had a second cancer with a higher proportion in Ws (20.8%) than in AA (12.4%) (p = .048). Approximately 99% of the respondents had surgical treatment of some type with no statistically significant differences between AAs and Ws in terms of type of surgery or in number of lymph nodes removed.

AA BCS were more likely than Ws to have reported swelling in the affected side (47.4% vs. 28.3%, p &lt; .001), however of those with swelling there were no statistically significant differences between AAs and Ws in terms of receiving treatment for that swelling (AA:46.6%, W:42.2%, p=.644), change in skin texture (p=.104), pitting (p=.773), or coloring (p=.087). White BCS were more likely than AA BCS to report normal range of motion of the affected side(s)-shoulder flexion 90.8% vs. 71.3%, p &lt; .001), shoulder abduction (86.6% vs. 67.8%, p &lt; .001)), and shoulder internal rotation (56.3% vs. 32.9%, p &lt; .001).

Significance: Our study suggests that AA BCS may experience a heavier burden of late effects of cancer treatment and have less financial means to help mitigate this burden. The next step is to use multivariate approaches to determine whether these disparities persist when accounting for other important control variables such as age, time since diagnosis, and level of comorbidity. African American, poor and medically underserved have often not been included in epidemiologic research and our study will provide critical data useful towards the development of interventions aimed at the eventual reduction in cancer survivorship burden due to breast cancer related physical and functional impairments.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A60.