TY - JOUR
T1 - Individual, social, and societal correlates of health-related quality of life among African American survivors of ovarian cancer
T2 - Results from the African American cancer epidemiology study
AU - Anderson, Roger T.
AU - Peres, Lauren C.
AU - Camacho, Fabian
AU - Bandera, Elisa V.
AU - Funkhouser, Ellen
AU - Moorman, Patricia G.
AU - Paddock, Lisa E.
AU - Peters, Edward S.
AU - Abbott, Sarah E.
AU - Alberg, Anthony J.
AU - Barnholtz-Sloan, Jill
AU - Bondy, Melissa
AU - Cote, Michele L.
AU - Schwartz, Ann G.
AU - Terry, Paul
AU - Schildkraut, Joellen M.
N1 - Funding Information:
This study was supported by the National Cancer Institute (R01CA142081). Additional support was provided by the Metropolitan Detroit Cancer Surveillance System with funding from the National Cancer Institute, National Institute of Health, and the Department of Health and Human Services (Contract HHSN261201000028C), and the Epidemiology Research Core, supported in part by the National Cancer Institute (P30CA22453) to the Karmanos Cancer Institute, Wayne State University School of Medicine. The New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, is funded by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute under contract HHSN261201300021I, the National Program of Cancer Registries (NPCR), Centers for Disease Control and Prevention under grant 5 U58DP003931-02, as well as the State of New Jersey and the Rutgers Cancer Institute of New Jersey.
Publisher Copyright:
© 2019 Mary Ann Liebert, Inc., publishers.
PY - 2019/2
Y1 - 2019/2
N2 - Objective: While the incidence of epithelial ovarian cancer (EOC) is lower among African American (AA) women compared with European American (EA) women, AA women have markedly worse outcomes. In this study, we describe individual, social, and societal factors in health-related quality of life (HRQL) in AA women diagnosed with EOC in the African American Cancer Epidemiology Study (AACES) that we hypothesize may influence a patient's capacity to psychosocially adjust to a diagnosis of cancer. Methods: There were 215 invasive EOC cases included in the analysis. HRQL was measured using the SF-8 component scores for physical (PCS) and mental (MCS) health. We used least squares regression to test the effects of individual dispositional factors (optimism and trait anxiety); social level (perceived social support); and societal-level factors (SES defined as low family income and low educational attainment, and perceived discrimination) on HRQL, while adjusting for patient age, tumor stage, body mass index, and comorbidity. Mediation analysis was applied to test whether social support and physical activity buffer impacts of EOC on HRQL. Results: Optimism, trait anxiety, social support, poverty, and past perceived discrimination were significantly associated with HRQL following diagnosis of EOC. Specifically, higher family income, lower phobic anxiety, and higher social support were associated with better wellbeing on the MCS and PCS (p < 0.01). Higher perceived discrimination was associated with both lower MCS and PCS, whereas higher optimism was associated with higher MCS. Physical activity (MET-min/week) and social support displayed significant overall mediation for effects of SES on MCS and PCS, but not for trait anxiety. Conclusions: Both pre-A nd postdiagnosis characteristics of AA women with EOC are important predictors of HRQL after cancer diagnosis. Individual, social, and societal-level factors each contribute to HRQL status with EOC and should be assessed.
AB - Objective: While the incidence of epithelial ovarian cancer (EOC) is lower among African American (AA) women compared with European American (EA) women, AA women have markedly worse outcomes. In this study, we describe individual, social, and societal factors in health-related quality of life (HRQL) in AA women diagnosed with EOC in the African American Cancer Epidemiology Study (AACES) that we hypothesize may influence a patient's capacity to psychosocially adjust to a diagnosis of cancer. Methods: There were 215 invasive EOC cases included in the analysis. HRQL was measured using the SF-8 component scores for physical (PCS) and mental (MCS) health. We used least squares regression to test the effects of individual dispositional factors (optimism and trait anxiety); social level (perceived social support); and societal-level factors (SES defined as low family income and low educational attainment, and perceived discrimination) on HRQL, while adjusting for patient age, tumor stage, body mass index, and comorbidity. Mediation analysis was applied to test whether social support and physical activity buffer impacts of EOC on HRQL. Results: Optimism, trait anxiety, social support, poverty, and past perceived discrimination were significantly associated with HRQL following diagnosis of EOC. Specifically, higher family income, lower phobic anxiety, and higher social support were associated with better wellbeing on the MCS and PCS (p < 0.01). Higher perceived discrimination was associated with both lower MCS and PCS, whereas higher optimism was associated with higher MCS. Physical activity (MET-min/week) and social support displayed significant overall mediation for effects of SES on MCS and PCS, but not for trait anxiety. Conclusions: Both pre-A nd postdiagnosis characteristics of AA women with EOC are important predictors of HRQL after cancer diagnosis. Individual, social, and societal-level factors each contribute to HRQL status with EOC and should be assessed.
KW - African American
KW - cancer survivorship
KW - ovarian cancer
KW - psychosocial predictors
KW - quality of life
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U2 - 10.1089/jwh.2018.7025
DO - 10.1089/jwh.2018.7025
M3 - Article
C2 - 30307782
AN - SCOPUS:85061586648
SN - 1540-9996
VL - 28
SP - 284
EP - 293
JO - Journal of women's health (2002)
JF - Journal of women's health (2002)
IS - 2
ER -