Abstract P1-10-13: Ethnic differences in quality of life, anxiety and depression and fatigue in breast cancer survivors
Authors: Ho PJ , Verkooijen HM , Gernaat S , Hartman M 
Published: May 2016

Abstract
Introduction: With the sharp increase in incidence and improving survival of breast cancer in Asia, survivorship issues, like fatigue, anxiety and depression and health related quality of life are becoming increasingly important. In the multi-ethnic setting of South East Asia, these items have been understudied.
Methods: This cross-sectional study included a random sample of 377 breast cancer patients visiting the breast care clinic of the National University Hospital for routine follow-up between April 2014 - April 2015. Patients were at least 12 months post diagnosis. Patient characteristics were collected from medical records. Malay (n=72) and Chinese (n=305) breast cancer patients were compared in terms of physical function, fatigue, and financial difficulties (as reported in the EORTC-QLQ-C30), and anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Clinically relevant fatigue (CRF) was defined as a score ≥40, and clinically relevant anxiety and depression were defined as scores of ≥8. Mann-Whitney U test and Fisher's exact test were used to compare patient reported outcomes between Chinese and Malays.
Results: The mean age at time of survey was 56.5 (range: 27-79), with 305 (74%) Chinese and 72 (18%) Malays. Median (Interquartile range) ages were 58 (52-64) for Chinese and 52 (46-57) for Malays; the distribution of age was significantly different (p&lt;0.001). Forty five (15%) Chinese and 8 (11%) Malays were originally diagnosed with in situ cancer, 98 (33%) and 18 (25%) with stage 1, 130 (43%) and 33 (46%) with stage 2, and 29 (10%) and 13 (18%) with stage 3 or 4; the distribution of stage was not different for Chinese and Malays (p=0.143). Overall quality of life was not significantly different for ethnicity, median were 67 (58-83) for Chinese and 75 (58-83) for Malays (p=0.773).
Ninety seven (26%) patients reported scores 8 and above for anxiety; with 80 (26%) Chinese and 17(24%) Malays (p=0.765). Sixty two (24%) patients reported scores of 8 and above for depression, with 55 (18%) Chinese and 7 (10%) Malays (p=0.111). Sixty two (24%) patients experienced clinically relevant fatigue, 44(14%) Chinese and 18 (25%) Malays (p=0.034). Malays experienced lower level of physical function than Chinese, 87 (73-93) vs 93 (87-100) respectively (p=0.004), and more financial difficulty, 33 (0-67) vs 0 (0-33) respectively (p&lt;0.001).
Conclusion:
One in 4 patients experience anxiety, depression, and/or clinically relevant fatigue. Malay breast cancer survivors, experience more clinically relevant fatigue and reduced physical functions compared to Chinese breast cancer survivors. In addition, they experienced more financial difficulties.
Citation Format: Ho PJ, Verkooijen HM, Gernaat S, Hartman M. Ethnic differences in quality of life, anxiety and depression and fatigue in breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-13.