title: Racial/ethnic differences in quality of life after diagnosis of breast cancer.
abstract: BACKGROUND
  Most studies on quality of life of breast cancer survivors have not had adequate representation of ethnic minorities. The purpose of this study was to determine whether racial/ethnic differences in quality of life exist between white, African American, and Latina women in the early stages of survivorship.
  
  
  METHODS
  2268 women were identified by two Surveillance, Epidemiology and End Results (SEER) registries (6/05-2/07) and asked to complete a survey (mean 9 months post-diagnosis, 72.1% response rate). Latina and African American women were over-sampled. Regression models compared quality of life across race/ethnicity (white, African American, Latina [low vs. high acculturation]), sequentially controlling for sociodemographics, clinical, and treatment factors.
  
  
  RESULTS
  There were significant racial/ethnic differences in quality of life controlling for sociodemographics, clinical factors and treatment factors. Lower acculturated Latinas compared to whites had significantly lower functional well-being, emotional well-being, and breast cancer concerns (p values < 0.05). African Americans had significantly higher emotional well-being than whites. Age, co-morbidities, cancer stage, and chemotherapy also influenced quality of life. A significant interaction was found between race/ethnicity and age for physical well-being (p = 0.041) and for emotional well-being (p = 0.042). Specifically, racial/ethnic differences were only observed among older women (>or=50 years), with less acculturated Latinas reporting the lowest quality of life.
  
  
  CONCLUSIONS
  Racial/ethnic differences in quality of life exist during the cancer survivorship period. Latinas with low acculturation are a particularly vulnerable subgroup.
  
  
  CONCLUSIONS
  Greater attention should be devoted to identifying women disproportionately affected by breast cancer and developing interventions targeting their unique survivorship concerns.
authors.affiliation: Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA. nkjanz@umich.edu
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.forename: Mahasin S
authors.initials: MS
authors.lastname: Mujahid
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Griggs
authors.forename: Amy
authors.initials: A
authors.lastname: Alderman
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.forename: John
authors.initials: J
authors.lastname: Graff
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology / Q000523:psychology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000208:ethnology / Q000473:pathology / Q000523:psychology*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D044469:Racial Groups; D017741:Survivors / Q000523:psychology; D055815:Young Adult