Race May Influence Quality of Life Among Colorectal Cancer Patients

A new study indicates racial disparities in health-related quality of life (HR-QoL) among patients with colorectal cancer, which may lead to shorter median survival.

While Hispanic and blacks were observed to have a higher burden of poor HR-QoL than whites, these populations had an average survival time of 85.4 months, compared with 47.8 months for blacks and 43.2 months for whites, according to a study presented at the annual meeting of the American Association for Cancer Research.

In the study, the authors measured HR-QoL among 366 Hispanic, 316 black, and 450 white patients with colorectal cancer. The authors looked closely at factors driving HR-QoL by racial group and how they effected survival.

"In this study, we focused on identification of patterns of racial disparities in health-related quality of life scores and relationship to differences in prognosis," said lead researcher Michelle Hildebrandt, PhD. "White, Hispanic and black colorectal cancer patients within one year of diagnosis at MD Anderson completed a quality of life questionnaire to determine mental and physical aspects of quality of life."

The authors used the Short-Form-12 survey (SF-12), which is a tool used to measure outcomes. The survey includes questions that assess functional health — Physical Composite Summary (PCS) – and mental health – Mental Composite Summary (MCS). According to the test, scored below 50 indicate poor quality of life compared with the general population.

Epidemiology and socio-demographic information was also obtained, as well as vital status and histology information.

"Racial disparities were reported in HR-QoL with both black and Hispanic patients reporting lower mean PCS and MCS scores compared to whites, suggesting poorer HR-QoL in these populations," Dr Hildebrandt said. "However, among colorectal patients reporting a poor PCS, we observed the highest median survival among Hispanics followed by blacks and whites. A similar relationship was seen for poor MCS scores stratified by race with mean survival times of 81.9 months for Hispanics, 54.1 months for blacks and 40.8 months for whites."

The authors found that unmarried Hispanic patients were 3 times as likely to have poor PCS scores compared with married patients. These findings were not observed among black or white patients, according to the study.

Additionally, Hispanic patients who received some college education were observed to have a lower risk of poor MCS, which was also not found among other races.

Both black and white females were found to have a 2-fold increased risk of poor PCS compared with men of the same race; however, these findings were not observed among Hispanics.

Although further studies are needed to confirm the findings, screening patients for potential factors that may result in poor HR-QoL could lead to increased monitoring and better outcomes.

"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," Dr Hildebrandt concluded.