Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas-Houston School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas-Houston School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Division of Management, Policy, and Community Health, The University of Texas-Houston School of Public Health, Houston, TX, USA.
Public Health. 2021 Jul;196:74-81. doi: 10.1016/j.puhe.2021.05.021. Epub 2021 Jun 20.
Breast cancer survivors have reported worse health-related quality of life (HRQoL) outcomes on some subscales when compared with members of the general population. However, the increased attention to breast cancer survivorship should have improved the HRQoL of these survivors. Our aim was to examine whether physical and mental component scores (PCS-12 and MCS-12) using the Short Form (SF-12) questionnaire were different for racial/ethnic minorities, specifically for Black and Hispanic women relative to White women. Furthermore, we stratified the data by age group to evaluate these racial/ethnic differences in HRQoL of breast cancer survivors.
Cross-sectional study.
Pooled cross-sectional analyses using data from the Medical Expenditure Panel Survey between 2008 and 2016 were conducted. Pooled ordinary least squares (OLS) regression was used to examine the racial/ethnic differences in PCS-12 and MCS-12 scores of breast cancer survivors. Furthermore, stratified analyses by age group were conducted to evaluate racial/ethnic differences in HRQoL by the age of breast cancer survivors.
After adjusting for confounders, there was no association between race/ethnicity and PCS-12 scores. However, Hispanic breast cancer survivors had statistically significantly lower MCS-12 scores (by 1.9 points [95% confidence interval {CI}: -3.53 to -0.37]) when compared with White breast cancer survivors. For PCS-12, after stratifying by age, the adjusted analyses showed no significant differences in PCS-12 scores when White female breast cancer survivors were compared with the other racial/ethnic categories. On the other hand, Black female survivors aged <50 years had 4.3 points (95% CI: 0.46-8.13) higher MCS-12 scores when compared with their White counterparts, while Hispanic breast cancer survivors aged <50 years had 3.1 points (95% CI: -0.40-6.69) higher MCS-12 scores relative to White women. Furthermore, among female breast cancer survivors aged ≥50 years, Hispanic women had 3.2 points (95% CI: -4.98 to -1.40) lower MCS-12 scores than White women.
Our study generated findings showing the racial/ethnic differences in HRQoL of breast cancer survivors and presented results stratified by age group. These findings provide the much-needed rationale for targeted and racial/ethnic-specific HRQoL improvement strategies among breast cancer survivors.
与一般人群相比,乳腺癌幸存者在某些亚量表上报告的健康相关生活质量(HRQoL)结果更差。然而,对乳腺癌生存者的日益关注应该改善这些生存者的 HRQoL。我们的目的是检查使用简短表格(SF-12)问卷的身体和心理成分评分(PCS-12 和 MCS-12)是否因种族/族裔差异而有所不同,特别是对于黑人女性和西班牙裔女性与白人女性相比。此外,我们按年龄组分层数据,以评估乳腺癌幸存者 HRQoL 的这些种族/族裔差异。
横断面研究。
使用 2008 年至 2016 年期间医疗支出面板调查的数据进行汇总横断面分析。使用 pooled 普通最小二乘法(OLS)回归来检查乳腺癌幸存者的 PCS-12 和 MCS-12 评分的种族/族裔差异。此外,还按年龄组进行分层分析,以评估乳腺癌幸存者 HRQoL 的种族/族裔差异。
在调整混杂因素后,种族/族裔与 PCS-12 评分之间没有关联。然而,与白人乳腺癌幸存者相比,西班牙裔乳腺癌幸存者的 MCS-12 评分显著降低(降低 1.9 分[95%置信区间(CI):-3.53 至-0.37])。对于 PCS-12,按年龄分层后,当将白人女性乳腺癌幸存者与其他种族/族裔类别进行比较时,调整后的分析显示 PCS-12 评分无显着差异。另一方面,年龄<50 岁的黑人女性幸存者的 MCS-12 评分比其白人同龄人高 4.3 分(95%CI:0.46-8.13),而年龄<50 岁的西班牙裔乳腺癌幸存者的 MCS-12 评分比白人女性高 3.1 分(95%CI:-0.40-6.69)。此外,在年龄≥50 岁的女性乳腺癌幸存者中,西班牙裔女性的 MCS-12 评分比白人女性低 3.2 分(95%CI:-4.98 至-1.40)。
我们的研究得出了有关乳腺癌幸存者 HRQoL 的种族/族裔差异的研究结果,并按年龄组进行了分层。这些结果为乳腺癌幸存者提供了有针对性和种族/族裔特异性的 HRQoL 改善策略的迫切需要的依据。