Roger T Anderson1, Lauren C Peres1, Fabian Camacho1, Elisa V Bandera2, Ellen Funkhouser3, Patricia G Moorman4, Lisa E Paddock5, Edward S Peters6, Sarah E Abbott1, Anthony J Alberg7,8, Jill Barnholtz-Sloan9, Melissa Bondy10, Michele L Cote11, Ann G Schwartz11, Paul Terry12, Joellen M Schildkraut1. 1. 1 Department of Public Health Sciences, University of Virginia , Charlottesville, Virginia. 2. 2 Department of Population Science, Rutgers Cancer Institute of New Jersey , New Brunswick, New Jersey. 3. 3 Division of Preventive Medicine, University of Alabama at Birmingham , Birmingham, Alabama. 4. 4 Department of Community and Family Medicine, Duke University Medical Center , Durham, North Carolina. 5. 5 Cancer Surveillance Research Program, New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey , New Brunswick, New Jersey. 6. 6 Epidemiology Program, Louisiana State University Health Sciences Center , School of Public Health, New Orleans, Louisiana. 7. 7 Department of Epidemiology, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina. 8. 8 Department of Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, South Carolina. 9. 9 Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine , Cleveland, Ohio. 10. 10 Cancer Prevention and Population Sciences Program, Baylor College of Medicine , Houston, Texas. 11. 11 Karmanos Cancer Institute Population Studies and Disparities Research Program, Department of Oncology, Wayne State University , Detroit, Michigan. 12. 12 Department of Medicine, University of Tennessee Medical Center-Knoxville , Knoxville, Tennessee.
Abstract
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- and 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.
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- and 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.
Entities:
Keywords:
cancer survivorship; ovarian cancer, quality of life, African American; psychosocial predictors
Authors: J E Epping-Jordan; B E Compas; D M Osowiecki; G Oppedisano; C Gerhardt; K Primo; D N Krag Journal: Health Psychol Date: 1999-07 Impact factor: 4.267
Authors: Lauren Clevenger; Andrew Schrepf; Koenraad Degeest; David Bender; Michael Goodheart; Amina Ahmed; Laila Dahmoush; Frank Penedo; Joseph Lucci; Premal H Thaker; Luis Mendez; Anil K Sood; George M Slavich; Susan K Lutgendorf Journal: Cancer Date: 2013-06-24 Impact factor: 6.860
Authors: Sarah E Abbott; Fabian Camacho; Lauren C Peres; Anthony J Alberg; Elisa V Bandera; Melissa Bondy; Michele L Cote; Ellen Funkhouser; Patricia G Moorman; Edward S Peters; Bo Qin; Ann G Schwartz; Jill Barnholtz-Sloan; Paul Terry; Joellen M Schildkraut Journal: Cancer Causes Control Date: 2017-11-29 Impact factor: 2.532
Authors: Joellen M Schildkraut; Anthony J Alberg; Elisa V Bandera; Jill Barnholtz-Sloan; Melissa Bondy; Michelle L Cote; Ellen Funkhouser; Edward Peters; Ann G Schwartz; Paul Terry; Kristin Wallace; Lucy Akushevich; Frances Wang; Sydnee Crankshaw; Patricia G Moorman Journal: BMC Cancer Date: 2014-09-22 Impact factor: 4.430