Abstract
Background
The co-occurrence of multiple chronic conditions in cancer patients is common and can have negative impact on cancer and cancer survivorship outcomes. This study aimed to document comorbidity occurrence among African-American and Latina (English language preferred (ELP) and Spanish language preferred (SLP)) breast cancer survivors (BCS).
Methods
Eighty-eight African-American, 95 ELP Latina, and 137 SLP Latina BCS were recruited via case ascertainment from the California Cancer Registry and hospital registries. BCS completed a self-report questionnaire assessing demographic and cancer characteristics, and presence of comorbidities.
Results
Overall, 75 % of BCS reported at least one comorbidity with arthritis (37 %), high blood pressure (37 %), psychological difficulties (29 %), and diabetes (19 %) being most commonly endorsed. SLP Latinas were more likely to report diabetes (29 %), psychological difficulties (42 %), and >3 comorbidities (p < 0.05). Latina BCS were twice as likely to report osteoporosis and headaches compared to African-Americans; while one in two African-Americans reported hypertension and arthritis. Older age was correlated with arthritis, diabetes, glaucoma, high blood pressure, and osteoporosis.
Conclusions
Our findings suggest that investigating the occurrence of comorbidities across ethnic groups may shed some light in understanding cancer survivorship risk for poor health outcomes and health disparities. Having a better grasp of comorbid conditions may aid in more appropriate early assessment, better follow-up care, surveillance, and management of the cancer and the comorbid condition(s).
Implications for Cancer Survivors
Integrated control and management of comorbidities among cancer survivors has the potential to improve quality care for the whole person, and increase survival and decrease morbidity.
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References
Land LH et al. Comorbidity and survival after early breast cancer: a review. Crit Rev Oncol/Hematol. 2012;81:196–205.
Koroukian SM, Murray P, Madigan E. Comorbidity, disability, and geriatric syndromes in elderly cancer patients receiving home health care. JCO. 2006;24(15):2304–10.
Ogle KS et al. Cancer and comorbidity: redefining chronic diseases. Cancer. 2000;88:653–63.
Smith AW et al. Cancer, comorbidities, and health related quality of life of older adults. Health Care Financ Rev. 2008;29(4):41–56.
Barone B et al. Postoperative mortality in cancer patients with preexisting diabetes: systematic review and meta-analysis. Diabetes Care. 2010;33(4):931–9.
Kumar S, Hurria A. Impact of age, sex, and comorbidity on cancer therapy and disease progression. JCO. 2010;28(26):4086–93.
Yancik R et al. Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 and older. JAMA. 2001;285(7):885–92.
Hershey DS et al. Perceived impact of cancer treatment on diabetes self-management. Diabetes Educ. 2012;38(6):779–90.
Berglund A et al. Impact of comorbidity on management and mortality in women diagnosed with breast cancer. Breast Cancer Res Treat. 2012;135:281–9.
Cronin-Fenton DP et al. Comorbidity and survival of Danish breast cancer patients from 1995-2005. Br J Cancer. 2007;96:1462–8.
Patnaik JL et al. The influence of comorbidities on overall survival among older women diagnosed with breast cancer. J Natl Cancer Inst. 2011;103(14):1101–11.
Peairs K et al. Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. JCO. 2011;29:40–6.
Polednak AP, Phillips CE. Obtaining data on comorbid diabetes among patients in a US population-based tumor registry. J Registry Manag. 2010;37(2):57–64.
Smith MR. Treatment-related diabetes and cardiovascular disease in prostate cancer survivors. Ann Oncol. 2008;19(Supp 7):vii86–90.
Vigneri P et al. Diabetes and cancer. Endocr-Relat Cancer. 2009;16:1103–23.
Braithwaite D et al. Prognostic impact of comorbidity among long-term breast cancer survivors: results from the LACE study. Cancer Epidemiol Biomark Prev. 2012;21(7):1115–25.
Tammemagi CM. Racial/ethnic disparities in breast and gynecologic cancer treatment and outcomes. Curr Opin Obstet Gynecol. 2007;19(1):31–6.
Tammemagi CM et al. Comorbidity and survival disparities among Black and White patients with breast cancer. JAMA. 2005;294(14):1765–72.
Louwman WJ et al. Less extensive treatment and inferior prognosis for breast cancer patient with comorbidity: a population-based study. Eur J Cancer. 2005;41(5):779–85.
Du XL, Fang S, Meyer T. Impact of treatment and socioeconomic status on racial disparities in survival among older women with breast cancer. Am J Clin Oncol. 2008;31(2):125–32.
Ashing-Giwa K, Ganz PA, Petersen L. Quality of life of African-American and White long-term breast cancer survivors. Cancer. 1999;85(2):418–26.
Napoles AM et al. Coping resources and self-rated health among Latina breast cancer survivors. Oncol Nurs Forum. 2011;38(5):523–31.
Extermann M. Measuring comorbidity in older cancer patients. Eur J Cancer. 2000;36(4):453–71.
Fleming ST et al. A comprehensive prognostic index to predict survival based on multiple comorbidities: a focus on breast cancer. Med Care. 1999;37(6):601–14.
Ashing-Giwa K, Rosales M. A cross-cultural validation of patient-reported outcome measures: a study of breast cancers survivors. Qual Life Res. 2013;22:295–308.
Ashing-Giwa K et al. Depressive symptomatology among Latina breast cancer survivors. 2013;22:845–53.
Janz NK et al. Racial/ethnic differences in quality of life after diagnosis of breast cancer. J Cancer Surviv. 2009;3:212–22.
Lopez ME et al. Ductal carcinoma in situ (DCIS): posttreatment follow-up care among Latina and non-Latina white women. J Caner Surviv. 2013;7(2):219–26.
Napoles AM et al. Interpersonal processes of care and patient satisfaction: do associations differ by race, ethnicity, and language? Health Serv Res. 2009;44(4):1326–44.
Ashing K, Rosales M (2013) A telephonic-based trial to reduce depressive symptoms among Latina breast cancer survivors. Psychooncology (in press)
Ashing-Giwa K et al. Breast cancer survivorship in a multiethnic sample: challenges in recruitment and measurement. Cancer. 2004;101(3):450–65.
Ashing-Giwa K et al. Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma. Qual Life Res. 2007;16(3):413–28.
Hurria A. Embracing the complexity of comorbidity. J Clin Oncol. 2011;29(32):4217–8.
Hurria A, Mohile S, Dale W. Research priorities in geriatric oncology: addressing the needs of an aging population. J Natl Compr Cancer Netw. 2012;10(2):286–8.
Ring A, Sestak I, Baum M. Influence of comorbidities and age on risk of death without recurrence: a retrospective analysis of the Arimidex, Tamoxifen Alone or in combination trial. J Clin Oncol. 2011;29(32):4266–72.
Dwight-Johnson M, Ell K, Lee P-J. Can collaborative care address the needs of low-income Latinas with comorbid depression and cancer? Results from a randomized pilot study. Psychosom. 2005;46(3):224–32.
Buki LP et al. Latina breast cancer survivors’ lived experiences: diagnosis, treatment, and beyond. Cult Divers Ethn Minor Psychol. 2008;14(2):163–7.
Ell K et al. Improving treatment of depression among low-income patients with cancer: the design of the ADAPt-C study. Gen Hosp Psychiatry. 2007;29:223–31.
Ell K et al. Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol. 2005;23(13):3052–60.
Eversley R et al. Post-treatment symptoms among ethnic minority breast cancer survivors. Oncol Nurs Forum. 2005;32(2):250–5.
Eley JW et al. Racial differences in survival from breast cancer: results of the National Cancer Institute Black/White cancer survival study. JAMA. 1994;272:947–54.
Ashing-Giwa K, Rosales M. Recruitment and retention strategies of African American and Latina American breast cancer survivors in a longitudinal psycho-oncology study. Oncol Nurs Forum. 2012;39(5):E434–42.
Parsons HM et al. What happens to racial and ethnic minorities after cancer surgery at American College of Surgeons national surgical quality improvement program hospitals? J Am Coll Sug. 2012;214(4):539–49.
Weaver KE et al. Forgoing medical care because of cost: assessing disparities in health care access among cancer survivors living in the United States. Cancer. 2010;116(14):3493–504.
Galvan N, Buki LP, Garces DM. Suddenly, a carriage appears: social support needs of Latina breast cancer survivors. J Psychosoc Oncol. 2009;27(3):361–82.
Acknowledgments
Research supported by a grant from the Department of Defense - Breast Cancer Research Program (W81XWH-04-1-0548).
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All authors have no potential conflicts of interest.
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Ashing, K., Rosales, M., Lai, L. et al. Occurrence of comorbidities among African-American and Latina breast cancer survivors. J Cancer Surviv 8, 312–318 (2014). https://doi.org/10.1007/s11764-014-0342-x
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DOI: https://doi.org/10.1007/s11764-014-0342-x