Investigators have found that Black cancer survivors who reported high levels of discrimination showed greater biological aging and frailty than those who reported lower levels of discrimination, according to a new study published by Mandelblatt et al in the journal Cancer.
Background
“Discrimination can act as a chronic stressor, which can throw the body off balance, resulting in increases in blood pressure, heart rate, metabolism, inflammation, and numerous other factors. These stressors can also increase rates of aging, leading to [a] greater risk of frailty,” explained lead study author Jeanne Mandelblatt, MD, MPH, Professor of Oncology and Medicine at the School of Medicine as well as Founder and Director of the Institute for Cancer and Aging Research at the Lombardi Comprehensive Cancer Center at Georgetown University. “We hypothesize that discrimination can lead to an older biological age than an [individual’s] actual chronological age. This is important to understand as there have been virtually no studies of the relationships between discrimination and aging in the setting of cancer survivorship.”
Additionally, cancer can accelerate the rate of aging because both the disease and its treatment destabilize and damage biological systems in the body.
Study Methods and Results
In the new study, the investigators surveyed 2,232 adult individuals who participated in the Detroit Research on Cancer Survivors Study—a population-based cohort of Black adult cancer survivors who had been diagnosed with breast, colorectal, lung, or prostate cancer within 5 years. They then analyzed the survey responses to questions regarding perceived discrimination—including those related to employment, education, renting and buying property, and treatment by police or neighbors—and used a deficit accumulation index to measure aging-related disease and function.
The investigators found that only 24.4% of participants had deficit accumulation scores indicating no signs of aging-related frailty. Further, two-thirds of the participants reported that they had experienced major discrimination in their lives. Survivors who had experienced four to seven types of discrimination events had the largest increase in deficits, even after controlling for age; time from diagnosis; cancer type, stage, and therapy; and sociodemographic variables.
Conclusions
“Our results indicate that after considering the effects of traditional factors on poor health—such as income, education, and types of cancer treatment—discrimination was significantly linked to frailty, independent of the other variables,” emphasized co–lead study author Ann Schwartz, PhD, MPH, Professor and Associate Chair of the Department of Oncology at the Wayne State University School of Medicine, and Deputy Director and Executive Vice President of Research and Academic Affairs at the Barbara Ann Karmanos Cancer Institute. “Regardless of whether you were rich or poor, if you experienced more discrimination, then you reported greater levels of frailty,” she concluded.
The researchers hope to conduct future studies further examining the intersectionality between aging, discrimination, and cancer survivorship among more diverse patient populations.
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
