Abstract B036: Self-perceived health status, poor physical and mental health days among cancer survivors with different socioeconomic status
Authors: O'Connor Sarah N. , Su L. Joseph 
Published: August 2020

Background: Health-related quality of life (HRQOL) is multidimensional and is composed of, at a minimum, self-perceived health status, physical functioning and psychological well-being. HRQOL measures reflect the extent of disability and dysfunction associated with a chronic disease such as cancer. Self-perceived health status is a good proxy for disease burden among cancer patients.

Purpose: This study used a nationally representative population survey to examine socioeconomic status disparities in HRQOL among survivors of thyroid, colon, lung, cervical, breast, prostate or ovarian cancer.

Methods: Data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey conducted by the CDC were used to examine factors associated with HRQOL among participants reported ever having been diagnosed with cancer. Typically, the cancer survivorship module is an optional component of the survey. However, the 2009 survey considered the cancer survivorship questions to be a core or required component of the survey. The BRFSS is a cross-sectional survey that assessed overall HRQOL, self-perceived health status, number of bad physical health and bad mental health days per month. Least square regression and logistic regression models, adjusting for confounding variables (e.g., age, gender, race/ethnicity, education level, and number of comorbidities), were used for ordinal and dichotomous (5 (bad) vs 1-4 (excellent, very good, good, fair)) scale of HRQOL, respectively.

Results: Among 432,607 surveyed, 59,173 reported ever been diagnosed with cancer. The seven most reported cancers were the focus of this study. Mean score for self-perceived health status (5-point scale) among survivors of thyroid, colon, lung, cervical, breast, prostate, and ovary was 2.83 (1.10), 3.15 (1.12), 3.68 (1.12), 2.98 (1.17), 2.93 (1.09), 2.94 (1.10), and 3.16 (1.18), respectively. After adjusting for confounders, a positive dose-response effect was observed between income level and all three HRQOL measures across all seven cancer sites. Income was consistently and inversely associated with a higher chance for reporting poorer HRQOL [OR: 0.64, 95% CI: 0.57-0.71], [OR: 0.63, 95% CI: 0.48-0.82], [OR: 0.67, 95% CI: 0.56-0.80], [OR: 0.69, 95% CI: 0.56-0.86], [OR: 0.55, 95% CI: 0.49-0.62], [OR:0.55, 95% CI: 0.44-0.69], [OR: 0.75, 95% CI: 0.62-0.91] among those with breast, thyroid, colon, lung, cervical, prostate, breast, and ovarian cancer, respectively. Race or ethnicity was not associated with in HRQOL among cancer survivors in the adjusted models.

Conclusion: This study found income, but not race or ethnicity, is associated with HRQOL among cancer survivors, after adjusting for confounders in this nationally representative survey population. Household income appears to be a strong predictor of HRQOL among cancer survivors. Despite potential survival bias in this cross-sectional survey, it is possible that financial resources may lessen the overall burden of cancer survivors.

Citation Format: Sarah N. O'Connor, L. Joseph Su. Self-perceived health status, poor physical and mental health days among cancer survivors with different socioeconomic status [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B036.