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Correlates of Quality of Life Among African American and White Cancer Survivors

Matthews, Alicia K. PhD; Tejeda, Silvia PhD; Johnson, Timothy P. PhD; Berbaum, Michael L. PhD; Manfredi, Clara PhD

doi: 10.1097/NCC.0b013e31824131d9

Background: African Americans continue to suffer disproportionately from cancer morbidity and mortality, with emerging evidence suggesting potential quality of life (QOL) disparities in the survivorship period.

Objective: The objective of the study was to assess sociodemographic, clinical, and psychosocial factors associated with physical and mental health QOL (PHQOL and MHQOL) among African American and white cancer survivors.

Methods: Patients were recruited from tumor registries. Telephone interviews were conducted with 248 African American and 244 white respondents with a history of breast, prostate, or colorectal cancers. Multivariate regression models were used to assess what factors were associated with PHQOL and MHQOL.

Results: Key racial differences in adjusted analyses included poorer MHQOL scores among African Americans compared with white survivors. Furthermore, race moderated the relationship between perceived social support and MHQOL, where higher social support levels were associated with increased MHQOL among African Americans. Other correlates of QOL impacted racial groups similarly. For example, factors associated with PHQOL scores included being unemployed, being uninsured, the presence of medical comorbidities, a longer time since diagnosis, and higher levels of cancer-related stress appraisals. Factors associated with MHQOL scores included being unemployed, higher levels of daily stress, higher levels of stress associated with the diagnosis, higher levels of education, higher levels of perceived social support, and higher levels of spirituality.

Conclusion: Interventions aimed at increasing social support may have important implications for improving QOL outcomes among African Americans.

Implications for Practice: Measuring and understanding factors associated with QOL have important implications for patient adjustment and clinical decision making.

Author Affiliations: College of Nursing (Dr Matthews), Institute for Health Research and Policy (Drs Tejeda, Johnson, Berbaum, and Manfredi), and Survey Research Laboratory (Dr Johnson), University of Illinois at Chicago.

Dr Matthews was with the Department of Psychiatry, University of Chicago, when this project was conducted.

This research was supported by grants from the National Cancer Institute: R01CA775-01A1 and R25CA057699.

The authors have no conflicts of interest to disclose.

Correspondence: Alicia K. Matthews, PhD, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612 (

Accepted for publication November 19, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.