Abstract 990: Patterns of racial disparities in health-related quality of life among colorectal cancer patients and relationship with survival
Authors: Hildebrandt Michelle A. T. , Belachew Alem A. , Reyes Monica E. , Ye Yuanqing , Wu Xifeng 
Published: July 2017

Distinct racial disparities are evident in CRC prognosis with Black patients experiencing worse outcomes than Hispanics and Whites. In a prior study of Health Related Quality of Life (HR-QoL) in a cohort of CRC patients, we observed that racial minority patients experienced lower HR-QoL scores compared to White CRC patients. Therefore, in this study, we focused on the identification of patterns of racial disparities in HR-QoL scores and relationship to differences in prognosis. White (N=450), Hispanic (N=366), and Black (N=316) CRC patients within 1 year of diagnosis at MD Anderson Cancer Center completed the SF-12 quality of life questionnaire to determine Mental Composite Summary (MCS) and Physical Composite Summary (PCS) scores. Participants also completed a questionnaire to collect epidemiology and sociodemographic variables. Vital status and histology information was obtained from the institutional tumor registry. Racial disparities were reported in HR-QoL with both Black and Hispanic patients reporting lower mean PCS and MCS scores compared to White patients, suggesting poorer HR-QoL in these populations. We observed differences in patterns of association between epidemiology and sociodemographic variables and poor HR-QoL by race. Hispanics who never married were at higher risk of poor physical HR-QoL (OR: 2.55(1.15-5.67), P=0.021) compared to married patients, which was not observed for White or Black CRC patients. Similarly, CRC patients with some college education was associated with a decreased risk of poor PCS, but only in Hispanics (OR: 0.26(0.13-0.52), P&lt;0.0001). White females have about two-fold risk of poor PCS (P=2.00 x 10-4) and MCS (P=2.21 x 10-4) scores compared to White males. This relationship was also observed for Black females OR: 2.28(1.35-3.84), but not Hispanic females. Among CRC patients reporting poor PCS (&lt;50), significant differences in median survival times (MSTs) were observed by race. Hispanic patients had the highest MST at 85.4 months followed by Blacks (47.8 months) and Whites (43.2 months). A similar relationship was observed for poor MCS (&lt;50) stratified by race with MST times of 81.9 months for Hispanics, 40.8 months for Blacks, and 54.1 months for Whites. In conclusion, we identified patterns of racial disparities in epidemiology and sociodemographic factors that correspond to poor baseline HR-QoL in CRC patients. We also demonstrated that a prognostic correlation exists between baseline HR-QoL and patient overall survival, and that this relationship is influenced by race. The patterns of racial disparity identified in this study can be an important tool for assessing the underlying mediators of HR-QoL in CRC patients and to further identify those who are particularly at risk for poor prognosis.

Citation Format: Michelle A. T. Hildebrandt, Alem A. Belachew, Monica E. Reyes, Yuanqing Ye, Xifeng Wu. Patterns of racial disparities in health-related quality of life among colorectal cancer patients and relationship with survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 990. doi:10.1158/1538-7445.AM2017-990