Survival Better for Hispanics, Blacks With Colorectal Cancer but HR-QoL Is Better for Whites

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Survey responses revealed racial differences in HR-QoL, with lower scores reported by black and Hispanic patients.
Survey responses revealed racial differences in HR-QoL, with lower scores reported by black and Hispanic patients.

A study of racial disparities in health-related quality of life (HR-QoL) for patients with colorectal cancer revealed that Hispanic and black patients experienced worse HR-QoL than white patients despite having longer mean survival times, according to research presented at the American Association for Cancer Research (AACR) Annual Meeting 2017.1

This study closely examined predictors of HR-QoL by race after a previous survey indicated poor HR-QoL among minority patients with colorectal cancer. The researchers examined how these predictors might relate to survival.

For the study, more than 1300 patients with colorectal cancer (316 blacks, 366 Hispanics, and 450 whites) were surveyed within 1 year of diagnosis. The researchers used Short-Form-12 survey (SF-12), a tool frequently used to assess patient outcomes. The 12 questions in SF-12 assess physical composite summary (PCS), which measures functional health, and mental composite summary (MCS), which measures mental health. The norm of SF-12 is set to 50 such that any values lower than 50 are considered poor quality of life compared with the general population.

Additionally, patients completed a questionnaire designed to extract epidemiology and socio-demographic factors. Vital status and histologic information was retrieved from the MD Anderson Cancer Center tumor registry.

Survey responses revealed racial differences in HR-QoL, with mean PCS and mean MCS scores lower among black and Hispanic patients compared with white patients. This finding suggests poorer HR-QoL in these patients, explained Michelle Hildebrandt, PhD, assistant professor of Epidemiology at The University of Texas MD Anderson Cancer Center, Houston.

Among patients with colorectal cancer, however, higher median survival was observed in Hispanics (85.4 months) followed by blacks (47.8 months) then whites (43.2 months) despite reporting a poor PCS. A similar relationship was seen for poor MCS scores stratified by race with mean survival times of higher for Hispanics (81.9 months) than for blacks (54.1 months) or for whites (40.8 months).2

Additionally, Hispanics who had never married were 3 times as likely to experience poor physical HR-QoL compared with those who had married. This result was not observed in black or white patients.

Hispanic patients with some college education experienced a lower risk of poor MCS; a correlation not seen in black or white patients.

Black and white women experienced twice the risk of poor PCS compared with men, although this correlation was not observed in Hispanic women.

“The patterns of racial disparity observed in this study can be an important tool for assessing the underlying mediators of HR-QoL in colorectal cancer patients and in further identifying patients who are particularly at risk for poor prognosis,” concluded Dr Hildebrandt.2

References

1. Hildebrandt MA, Belachew AA, Reyes ME, Ye Y, Wu X. Patterns of racial disparities in health-related quality of life among colorectal cancer patients and relationship with survival. Paper presented at: AACR Annual Meeting 2017; April 1-5, 2017; Washington DC

2. Minority colorectal cancer patients report higher burden of poor quality-of-life than whites [news release]. Houston, TX: The University of Texas MD Anderson Cancer Center; March 27, 2017. https://www.mdanderson.org/newsroom/2017/03/minority-colorectal-cancer-patients-report-higher-burden-of-poor-quality-of-life-than-whites.html. Accessed April 12, 2017.

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