Abstract C45: Assessing similarities and differences in health-related quality of life among African American women with and without breast cancer
Authors: Smith Selina A. , Claridy Mechelle D. , Whitehead Mary S. , Sheats Joyce Q. , Alema-Mensah Ernest 
Published: May 2015

Background: While current incidence rates are 4% lower for African American compared to white women (118 v. 123 per 100,000); African-American women are more likely to be diagnosed with breast cancer at younger ages with more aggressive and advanced tumors. Consequently, death rates are 41% higher for African-American women as compared to whites. This disparity may also extend to nonclinical outcomes, including health-related quality of life (HR-QoL). When compared to their white counterparts, consistent patterns in HR-QoL deficits have been noted among African-American women with and without breast cancer. It is important to examine the impact of physical, social and psychological factors on health outcomes in greater detail. The present study compares HR-QoL among African-American women without breast cancer, to those with breast cancer and other cancers from a national representative sample to a community cohort. The primary purpose was to assess similarities and differences in HR-QoL among African-American women with and without a history of breast cancer. We hypothesized that African American women with breast cancer would report poorer HR-QoL than those without breast cancer.

Methods: Three cohorts of African-American women from the 2010 National Health Interview Survey (NHIS): without cancer (n=1,348); with breast cancer (n=50) and with other cancers (n=82) were compared to participants from Survivors Involving Supporters to Take Action in Advancing Health (SISTAAH Talk) breast cancer support group (n=70) to assess HR-QoL characterized by recent physical and mental health using the Patient Reported Outcomes Measurement Information System (PROMIS) v. 1.0 Global Health Scale. Descriptive statistics were completed to characterize study participants demographics. Multivariate regression analyses estimated differences in respondents' HR-QoL.

Results: Demographic differences were noted among study cohorts. Proportionately, more African-American women with any cancer were 50 years or older compared to respondents without cancer. Significantly more SISTAAH Talk respondents were: 1) married when compared to NHIS respondents with breast cancer (p=0.0148) and with other cancers (p = 0.0042) and 2) better educated than NHIS respondents without cancer (p&lt;.0001) or with breast cancer (p&lt;.0001). When we controlled for these differences, compared to SISTAAH Talk respondents, NHIS respondents without cancer were significantly more likely to report: 1) good-to-excellent physical functioning; 2) little-to-no-pain; 3) little fatigue and 4) rarely-or-never experiencing emotional difficulties for the past seven days. In contrast, NHIS respondents with other cancers were more likely to report: 1) little-to-no fatigue and 2) never-to-rarely experience emotional difficulties than SISTAAH Talk respondents.

Conclusions/Discussion: Based on similar studies, we hypothesized that African American breast cancer survivors would have poorer HR-QoL than their cancer-free counterparts. Our results, however, suggested the opposite, for the following reasons: 1) noted differences in HR-QoL between SISTAAH Talk respondents and African-American women in the NHIS cohorts may be related to support group participation; 2) SISTAAH Talk respondents were more likely married, have more education with higher incomes, all of which are associated with better health resulting in 3) higher overall mental and physical health scores (higher than the national norm of 50). Additional research is needed to determine reasons for differences in HR-QoL among African- American women with and without breast cancer.

Funding Source: This research is supported by: National Cancer Institute (Grant #: 1R01CA166785-02 and U54 CA118638-08) and National Institute of Minority Health & Health Disparities (Grant #: 1P20 MD006881-01).

Citation Format: Selina A. Smith, Mechelle D. Claridy, Mary S. Whitehead, Joyce Q. Sheats, Ernest Alema-Mensah. Assessing similarities and differences in health-related quality of life among African American women with and without breast cancer. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C45. doi:10.1158/1538-7755.DISP13-C45