Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer

A report from the Childhood Cancer Survivor Study

Stephanie B. Dixon, Nan Li, Yutaka Yasui, Smita Bhatia, Jacqueline N. Casillas, Todd M. Gibson, Kirsten K. Ness, Jerlym S. Porter, Rebecca M. Howell, Wendy M. Leisenring, Leslie L. Robison, Melissa M. Hudson, Kevin R. Krull, Gregory Armstrong

Research output: Contribution to journalArticle

Abstract

Background: Survivors of childhood cancer are at risk of neurocognitive impairment, emotional distress, and poor health-related quality of life (HRQOL); however, the effect of race/ethnicity is understudied. The objective of this study was to identify race/ethnicity-based disparities in neurocognitive, emotional, and HRQOL outcomes among survivors of childhood cancer. Methods: Self-reported measures of neurocognitive function, emotional distress (the Brief Symptom Inventory-18), and HRQOL (the Medical Outcomes Study Short Form-36 health survey) were compared between minority (Hispanic, n = 821; non-Hispanic black [NHB], n = 600) and non-Hispanic white (NHW) (n = 12,287) survivors from the Childhood Cancer Survivor Study (median age, 30.9 years; range, 16.0-54.1 years). By using a sample of 3055 siblings, the magnitude of same-race/same-ethnicity survivor-sibling differences was compared between racial/ethnic groups, adjusting for demographic and treatment characteristics and current socioeconomic status (SES). Results: No clear pattern of disparity in neurocognitive outcomes by race/ethnicity was observed. The magnitude of the survivor-sibling difference in the mean score for depression was greater in Hispanics than in NHWs (3.59 vs 1.09; P =.004). NHBs and Hispanics had greater survivor-sibling differences in HRQOL than NHWs for mental health (NHBs: −5.78 vs −0.69; P =.001; Hispanics: −3.87 vs −0.69; P =.03), and social function (NHBs: −7.11 vs −1.47; P <.001; Hispanics: −5.33 vs −1.47; P =.001). NHBs had greater survivor-sibling differences in physical subscale scores for HRQOL than NHWs. In general, the findings were not attenuated by current SES. Conclusions: Although no pattern of disparity in neurocognitive outcomes was observed, differences across many HRQOL outcomes among minorities compared with NHWs, not attenuated by current SES, were identified. This suggests that further research into environmental and sociocultural factors during and immediately after treatment is needed.

Original languageEnglish (US)
JournalCancer
DOIs
StatePublished - Jan 1 2019

Fingerprint

Survivors
Quality of Life
Hispanic Americans
Siblings
Neoplasms
Social Class
Health Surveys
Ethnic Groups
Mental Health
Demography
Outcome Assessment (Health Care)
Depression
Equipment and Supplies
Therapeutics
Research

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. / Dixon, Stephanie B.; Li, Nan; Yasui, Yutaka; Bhatia, Smita; Casillas, Jacqueline N.; Gibson, Todd M.; Ness, Kirsten K.; Porter, Jerlym S.; Howell, Rebecca M.; Leisenring, Wendy M.; Robison, Leslie L.; Hudson, Melissa M.; Krull, Kevin R.; Armstrong, Gregory.

In: Cancer, 01.01.2019.

Research output: Contribution to journalArticle

Dixon, SB, Li, N, Yasui, Y, Bhatia, S, Casillas, JN, Gibson, TM, Ness, KK, Porter, JS, Howell, RM, Leisenring, WM, Robison, LL, Hudson, MM, Krull, KR & Armstrong, G 2019, 'Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study', Cancer. https://doi.org/10.1002/cncr.32370
Dixon, Stephanie B. ; Li, Nan ; Yasui, Yutaka ; Bhatia, Smita ; Casillas, Jacqueline N. ; Gibson, Todd M. ; Ness, Kirsten K. ; Porter, Jerlym S. ; Howell, Rebecca M. ; Leisenring, Wendy M. ; Robison, Leslie L. ; Hudson, Melissa M. ; Krull, Kevin R. ; Armstrong, Gregory. / Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. In: Cancer. 2019.
@article{ca327fdfa01e4389801bb23cff3e8adc,
title = "Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study",
abstract = "Background: Survivors of childhood cancer are at risk of neurocognitive impairment, emotional distress, and poor health-related quality of life (HRQOL); however, the effect of race/ethnicity is understudied. The objective of this study was to identify race/ethnicity-based disparities in neurocognitive, emotional, and HRQOL outcomes among survivors of childhood cancer. Methods: Self-reported measures of neurocognitive function, emotional distress (the Brief Symptom Inventory-18), and HRQOL (the Medical Outcomes Study Short Form-36 health survey) were compared between minority (Hispanic, n = 821; non-Hispanic black [NHB], n = 600) and non-Hispanic white (NHW) (n = 12,287) survivors from the Childhood Cancer Survivor Study (median age, 30.9 years; range, 16.0-54.1 years). By using a sample of 3055 siblings, the magnitude of same-race/same-ethnicity survivor-sibling differences was compared between racial/ethnic groups, adjusting for demographic and treatment characteristics and current socioeconomic status (SES). Results: No clear pattern of disparity in neurocognitive outcomes by race/ethnicity was observed. The magnitude of the survivor-sibling difference in the mean score for depression was greater in Hispanics than in NHWs (3.59 vs 1.09; P =.004). NHBs and Hispanics had greater survivor-sibling differences in HRQOL than NHWs for mental health (NHBs: −5.78 vs −0.69; P =.001; Hispanics: −3.87 vs −0.69; P =.03), and social function (NHBs: −7.11 vs −1.47; P <.001; Hispanics: −5.33 vs −1.47; P =.001). NHBs had greater survivor-sibling differences in physical subscale scores for HRQOL than NHWs. In general, the findings were not attenuated by current SES. Conclusions: Although no pattern of disparity in neurocognitive outcomes was observed, differences across many HRQOL outcomes among minorities compared with NHWs, not attenuated by current SES, were identified. This suggests that further research into environmental and sociocultural factors during and immediately after treatment is needed.",
author = "Dixon, {Stephanie B.} and Nan Li and Yutaka Yasui and Smita Bhatia and Casillas, {Jacqueline N.} and Gibson, {Todd M.} and Ness, {Kirsten K.} and Porter, {Jerlym S.} and Howell, {Rebecca M.} and Leisenring, {Wendy M.} and Robison, {Leslie L.} and Hudson, {Melissa M.} and Krull, {Kevin R.} and Gregory Armstrong",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/cncr.32370",
language = "English (US)",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Racial and ethnic disparities in neurocognitive, emotional, and quality-of-life outcomes in survivors of childhood cancer

T2 - A report from the Childhood Cancer Survivor Study

AU - Dixon, Stephanie B.

AU - Li, Nan

AU - Yasui, Yutaka

AU - Bhatia, Smita

AU - Casillas, Jacqueline N.

AU - Gibson, Todd M.

AU - Ness, Kirsten K.

AU - Porter, Jerlym S.

AU - Howell, Rebecca M.

AU - Leisenring, Wendy M.

AU - Robison, Leslie L.

AU - Hudson, Melissa M.

AU - Krull, Kevin R.

AU - Armstrong, Gregory

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Survivors of childhood cancer are at risk of neurocognitive impairment, emotional distress, and poor health-related quality of life (HRQOL); however, the effect of race/ethnicity is understudied. The objective of this study was to identify race/ethnicity-based disparities in neurocognitive, emotional, and HRQOL outcomes among survivors of childhood cancer. Methods: Self-reported measures of neurocognitive function, emotional distress (the Brief Symptom Inventory-18), and HRQOL (the Medical Outcomes Study Short Form-36 health survey) were compared between minority (Hispanic, n = 821; non-Hispanic black [NHB], n = 600) and non-Hispanic white (NHW) (n = 12,287) survivors from the Childhood Cancer Survivor Study (median age, 30.9 years; range, 16.0-54.1 years). By using a sample of 3055 siblings, the magnitude of same-race/same-ethnicity survivor-sibling differences was compared between racial/ethnic groups, adjusting for demographic and treatment characteristics and current socioeconomic status (SES). Results: No clear pattern of disparity in neurocognitive outcomes by race/ethnicity was observed. The magnitude of the survivor-sibling difference in the mean score for depression was greater in Hispanics than in NHWs (3.59 vs 1.09; P =.004). NHBs and Hispanics had greater survivor-sibling differences in HRQOL than NHWs for mental health (NHBs: −5.78 vs −0.69; P =.001; Hispanics: −3.87 vs −0.69; P =.03), and social function (NHBs: −7.11 vs −1.47; P <.001; Hispanics: −5.33 vs −1.47; P =.001). NHBs had greater survivor-sibling differences in physical subscale scores for HRQOL than NHWs. In general, the findings were not attenuated by current SES. Conclusions: Although no pattern of disparity in neurocognitive outcomes was observed, differences across many HRQOL outcomes among minorities compared with NHWs, not attenuated by current SES, were identified. This suggests that further research into environmental and sociocultural factors during and immediately after treatment is needed.

AB - Background: Survivors of childhood cancer are at risk of neurocognitive impairment, emotional distress, and poor health-related quality of life (HRQOL); however, the effect of race/ethnicity is understudied. The objective of this study was to identify race/ethnicity-based disparities in neurocognitive, emotional, and HRQOL outcomes among survivors of childhood cancer. Methods: Self-reported measures of neurocognitive function, emotional distress (the Brief Symptom Inventory-18), and HRQOL (the Medical Outcomes Study Short Form-36 health survey) were compared between minority (Hispanic, n = 821; non-Hispanic black [NHB], n = 600) and non-Hispanic white (NHW) (n = 12,287) survivors from the Childhood Cancer Survivor Study (median age, 30.9 years; range, 16.0-54.1 years). By using a sample of 3055 siblings, the magnitude of same-race/same-ethnicity survivor-sibling differences was compared between racial/ethnic groups, adjusting for demographic and treatment characteristics and current socioeconomic status (SES). Results: No clear pattern of disparity in neurocognitive outcomes by race/ethnicity was observed. The magnitude of the survivor-sibling difference in the mean score for depression was greater in Hispanics than in NHWs (3.59 vs 1.09; P =.004). NHBs and Hispanics had greater survivor-sibling differences in HRQOL than NHWs for mental health (NHBs: −5.78 vs −0.69; P =.001; Hispanics: −3.87 vs −0.69; P =.03), and social function (NHBs: −7.11 vs −1.47; P <.001; Hispanics: −5.33 vs −1.47; P =.001). NHBs had greater survivor-sibling differences in physical subscale scores for HRQOL than NHWs. In general, the findings were not attenuated by current SES. Conclusions: Although no pattern of disparity in neurocognitive outcomes was observed, differences across many HRQOL outcomes among minorities compared with NHWs, not attenuated by current SES, were identified. This suggests that further research into environmental and sociocultural factors during and immediately after treatment is needed.

UR - http://www.scopus.com/inward/record.url?scp=85068762075&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068762075&partnerID=8YFLogxK

U2 - 10.1002/cncr.32370

DO - 10.1002/cncr.32370

M3 - Article

JO - Cancer

JF - Cancer

SN - 0008-543X

ER -