title: Post-treatment problems of African American breast cancer survivors.
abstract: African American breast cancer survivors (AABCS) have a lower survival rate across all disease stages (79 %) compared with White survivors (92 %) and often have more aggressive forms of breast cancer requiring multimodality treatment, so they could experience a larger burden of post-treatment quality of life (QOL) problems. This paper reports a comprehensive assessment of the number, severity, and domains of problems faced by AABCS within 5 years after treatment completion and identifies subgroups at risk for these problems.
  
  
  
  A population-based random sample was obtained from the Pennsylvania Cancer Registry of African American females over 18 years of age who completed primary treatment for breast cancer in the past 5 years. A mailed survey was used to document survivorship problems.
  
  
  
  Two hundred ninety-seven AABCS completed the survey. The median number of survivor problems reported was 15. Exploratory factor analysis of the problem scale revealed four domains: emotional problems, physical problems, lack of resources, and sexuality problems. Across problem domains, younger age, more comorbid conditions, and greater medical mistrust were risk factors for more severe problems.
  
  
  
  The results demonstrated that AABCS experienced significant problem burden in the early years after diagnosis and treatment. In addition to emotional and physical problem domains that were documented in previous research, two problem domains unique to AABCS included lack of resources and sexuality concerns. At risk groups should be targeted for intervention. The study results reported in this manuscript will inform future research to address problems of AABCS as they make the transition from cancer patient to cancer survivor.
authors.affiliation: Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA. Andrea.barsevick@jefferson.edu.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Barsevick
authors.affiliation: Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Leader
authors.affiliation: Villanova University, Villanova, PA, USA.
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Bradley
authors.affiliation: Wake Forest University, Winston-Salem, NC, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Avery
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Lorraine T
authors.initials: LT
authors.lastname: Dean
authors.affiliation: Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: DiCarlo
authors.affiliation: Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA, 19107, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hegarty
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors / Q000523:psychology; D016896:Treatment Outcome
keywords: African American; Breast cancer; Cancer survivor; Disparities; Medical mistrust; Quality of life