Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California.
Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Cancer Epidemiol Biomarkers Prev. 2024 Feb 6;33(2):254-260. doi: 10.1158/1055-9965.EPI-23-0789.
It is unclear whether health-related quality of life (HRQOL) disparities exist between racial/ethnic groups in older patients with esophageal cancer, pre- and post-diagnosis.
Using the SEER-MHOS (Surveillance, Epidemiology, and End Results and Medicare Health Outcomes Survey) national database, we included patients ages 65-years-old or greater with esophageal cancer diagnosed from 1996 to 2017. HRQOL data within 36 months before and after diagnosis were measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores from the SF-36 and VR-12 instruments. Total combined score (TCS) was reflected by both PCS and MCS.
We identified 1,312 patients, with evaluable data on 873 patients pre-diagnosis and 439 post-diagnosis. On pre-diagnosis cohort MVA, the MCS was better for White over Hispanic patients (54.1 vs. 48.6, P = 0.012). On post-diagnosis cohort MVA, PCS was better for Hispanic compared with White (39.8 vs. 34.5, P = 0.036) patients, MCS was better for Asian compared with White (48.9 vs. 40.9, P = 0.034) patients, and TCS better for Asian compared with White (92.6 vs. 76.7, P = 0.003) patients.
In older patients with esophageal cancer, White patients had better mental HRQOL as compared with Hispanic patients pre-diagnosis. However, post-diagnosis, White patients had worse mental and physical HRQOL compared with Asian and Hispanic patients, respectively, suggesting a greater negative impact on self-reported HRQOL in White patients with esophageal cancer.
To our knowledge, this study is the first to explore HRQOL differences in patients with esophageal cancer of various racial and ethnic groups and warrants further validation in future studies.
在患有食管癌的老年患者中，种族/民族之间在诊断前后的健康相关生活质量（HRQOL）是否存在差异尚不清楚。
使用 SEER-MHOS（监测、流行病学和最终结果与医疗保险健康结果调查）国家数据库，我们纳入了 1996 年至 2017 年间诊断为食管癌且年龄在 65 岁或以上的患者。在诊断前后 36 个月内通过 SF-36 和 VR-12 仪器的身体成分综合评分（PCS）和心理成分综合评分（MCS）来测量 HRQOL 数据。PCS 和 MCS 的总综合评分（TCS）反映了两者。
我们确定了 1312 名患者，其中 873 名患者在诊断前有可评估数据，439 名患者在诊断后有可评估数据。在诊断前队列的多变量分析中，白人患者的 MCS 好于西班牙裔患者（54.1 比 48.6，P = 0.012）。在诊断后队列的多变量分析中，与白人患者相比，西班牙裔患者的 PCS 更好（39.8 比 34.5，P = 0.036），亚洲裔患者的 MCS 更好（48.9 比 40.9，P = 0.034），TCS 更好亚洲裔患者比白人患者（92.6 比 76.7，P = 0.003）。
在患有食管癌的老年患者中，白人患者在诊断前的心理健康 HRQOL 好于西班牙裔患者。然而，与亚洲和西班牙裔患者相比，白人患者在诊断后分别有更差的心理健康和身体状况 HRQOL，这表明食管癌白人患者自我报告的 HRQOL 受到更大的负面影响。
据我们所知，这项研究是首次探索不同种族和民族的食管癌患者的 HRQOL 差异，需要在未来的研究中进一步验证。
