School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, USA.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Support Care Cancer. 2024 Mar 12;32(4):224. doi: 10.1007/s00520-024-08429-y.
This study aimed to examine relationships between health-related quality of life (HRQOL), social determinants of health, and neighborhood socioeconomic disadvantage in individuals with early-stage breast cancer (ESBC) during chemotherapy.
This is a longitudinal study that recruited Black and White women with ESBC receiving chemotherapy. Participants completed questionnaires recording their sociodemographic information at baseline and the Functional Assessment of Cancer Therapy-General (FACT-G) to report their HRQOL before each chemotherapy cycle. Linear mixed modeling was employed to examine the associations between FACT-G scores, self-reported race, and area deprivation index (ADI) before and at the last chemotherapy cycle, with the duration of chemotherapy treatment as a covariate.
A total of 84 Black and 146 White women with ESBC completed the surveys. Linear mixed modeling results suggested that women with ESBC who reported being Black experienced significantly worse physical well-being than those who reported being White throughout chemotherapy, with a 0.22-point lower average (p = 0.02). Both Black and White women with ESBC experienced decreased functional well-being over the chemotherapy, and Black women consistently reported lower scores than White women, with the change in functional well-being over time differing between racial groups (p = 0.03). Participants' ADI national percentiles were not significantly associated with their HRQOL throughout chemotherapy.
These findings underscore possible racial differences in some dimensions of HRQOL during chemotherapy among women with ESBC. Future research should consider further assessing life stressors and past experiences of discrimination and racism that may contribute to these disparities and guide proactive interventions.
本研究旨在探讨健康相关生活质量（HRQOL）、健康的社会决定因素与早期乳腺癌（ESBC）患者化疗期间邻里社会经济劣势之间的关系。
这是一项纵向研究，招募了接受化疗的 ESBC 的黑人和白人女性。参与者在基线时完成了记录其社会人口统计学信息的问卷，并在每个化疗周期前填写了癌症治疗功能评估一般量表（FACT-G）以报告其 HRQOL。线性混合模型用于检查 FACT-G 评分、自我报告的种族和区域剥夺指数（ADI）在化疗前和最后一次化疗周期之间的关系，化疗治疗持续时间作为协变量。
共有 84 名黑人和 146 名白人 ESBC 女性完成了调查。线性混合模型结果表明，报告为黑人的 ESBC 女性在整个化疗期间经历的身体整体健康状况明显比报告为白人的女性差，平均低 0.22 分（p=0.02）。接受化疗的黑人和白人 ESBC 女性的功能整体健康状况均有所下降，黑人女性的报告分数始终低于白人女性，不同种族群体之间的功能整体健康状况随时间的变化存在差异（p=0.03）。参与者的 ADI 国家百分位数与整个化疗期间的 HRQOL 无显著相关性。
这些发现强调了 ESBC 女性在化疗期间某些 HRQOL 维度可能存在种族差异。未来的研究应进一步评估可能导致这些差异的生活压力源和过去的歧视和种族主义经历，并指导积极的干预措施。
