AACR 2017: Minority Patients With Colorectal Cancer Report Higher Burden of Poor Quality-of-Life Than Whites

Key Points

  • Racial disparities were reported in health-related quality of life, with both black and Hispanic patients reporting lower mean PCS and MCS scores compared to whites.
  • However, among colorectal patients reporting a poor PCS, the highest median survival was observed among Hispanics, followed by blacks and whites.
  • A similar relationship was seen for poor MCS scores stratified by race, with mean survival times of 81.9 months for Hispanics, 54.1 months for blacks, and 40.8 months for whites.

A study presented by Hildebrandt et al at the 2017 Annual Meeting of the American Association of Cancer Research (AACR; Abstract 990) revealed several findings about racial disparities in health-related quality of life among colorectal cancer patients. Hispanics and blacks had a higher burden of poor health-related quality of life than white patients, and poor health-related quality of life resulted in shorter median survival. Yet Hispanics had an average survival time of 85.4 months as compared to blacks at 47.8 months and whites at 43.2 months.

Study Details

The study, led by Michelle Hildebrandt, PhD, Assistant Professor of Epidemiology at The University of Texas MD Anderson Cancer Center, followed up on a prior MD Anderson survey that observed lower health-related quality-of-life scores among minorities compared to white colorectal patients. The research looked more closely at predictors of health-related quality of life by racial group and how these differences were linked to colorectal cancer survival. The study surveyed 450 white, 366 Hispanic, and 316 black patients. 

“In this study, we focused on identification of patterns of racial disparities in health-related quality of life scores and relationship to differences in prognosis,” said Dr. Hildebrandt.  “White, Hispanic, and black patients [with colorectal cancer who were] within 1 year of diagnosis at MD Anderson completed a quality-of-life questionnaire to determine mental and physical aspects of quality of life.”

Dr. Hildebrandt employed the Short-Form-12 survey (SF-12), a commonly used tool to measure patient outcomes, with twelve questions designed to assess functional health or Physical Composite Summary (PCS) and mental well-being or Mental Composite Summary (MCS). Patients also completed a questionnaire to collect epidemiology and sociodemographic variables. Vital status and histology information was obtained from MD Anderson’s tumor registry. In the SF-12, the “norm” is set at 50, so anything below 50 is considered a poor quality of life compared to the general population.

Study Findings

“Racial disparities were reported in health-related quality of life, with both black and Hispanic patients reporting lower mean PCS and MCS scores compared to whites, suggesting poorer health-related quality of life in these populations,” said Dr. Hildebrandt. “However, among colorectal patients reporting a poor PCS, we observed the highest median survival among Hispanics, followed by blacks and whites. A similar relationship was seen for poor MCS scores stratified by race, with mean survival times of 81.9 months for Hispanics, 54.1 months for blacks, and 40.8 months for whites.”

Among other study findings were the following:

  • Hispanics who had never married were at a three times as likely to have a poor physical health-related quality of life when compared to married patients, which was not observed in white and black colorectal patients.
  • Hispanic colorectal patients with some college education were associated with a decreased risk of poor MCS, a finding that did not apply equally to the other racial categories.
  • White and black females have a two-fold risk of poor PCS compared to men, which was not observed among Hispanic females.

“The patterns of racial disparity observed in this study can be an important tool for assessing the underlying mediators of health-related quality of life in [patients with] colorectal cancer and in further identifying patients who are particularly at risk for poor prognosis,” said Dr. Hildebrandt.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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